A CASE OF LYMPHEDEMA OF LOWER EXTEREMITY DUE TO RETROPERITONEAL FIBROSIS (ORMOND SYNDROME) WITH DIFFICULTY IN DIAGNOSIS

Abstract

There have been few reports of lymphedema due to retroperitoneal fibrosis (Ormond syndrome) so far. We report such a rare case with some bibliographical comments.A 50-year-old man was seen at the hospital because of swelling of the right lower extremity, pain and hot sensation. Lymphatic scintigraphy revealed congestion of lymph of the right lower extremity. Phlegmonous inflammation caused by lymphedema was diagnosed, and administration of antibiotics and anti-inflammatory drugs, elevation of the lowe extremity, and physical therapies including Hadmer were conducted. However, the edema gradually because worse to reach the scrotum. A CT scan and magnetic resonance imaging visualized illdefined soft parts tumorous lesion along the right lateral wall of the pelvic. On imaging methods, we could not diagnose the case as inflammatory disease, retroperitoneal fibrosis, or lymphoma. So a laparotomy was performed. Intraoperative frozen section diagnosis was retroperitoneal fibrosis and then fibrous tissues were removed. Postoperative course was uneventful. The patient was discharged from the hospital after remission in swelling of the lower extremity.