Case Of Retroperitoneal Fibrosis Research Articles

Asbestos exposure: A potential cause of retroperitoneal fibrosis

The etiology of retroperitoneal fibrosis is unknown in 70% of the cases. The aim of our study was to examine the possible association between occupational asbestos exposure and retroperitoneal fibrosis; only two cases have been reported in the literature. We gathered all the cases of retroperitoneal fibrosis diagnosed in the Tampere University Hospital between 1987 and 1995. We examined their hospital records to evaluate the possible etiology of the disease. We also sent a structured questionnaire to all living patients (10/13) to obtain information on their asbestos exposure. The chest radiographs of the patients were re-read to evaluate possible changes resulting from asbestos exposure. We found 13 cases of idiopathic retroperitoneal fibrosis. Seven patients (all male) had been exposed to asbestos in the past. The chest radiographs of the four most-exposed patients showed characteristic asbestos-related abnormalities, including bilateral pleural plaques, round atelectasis and small irregular lung opacities. In our study, we found that asbestos exposure and asbestos-induced changes in the lung and pleura were common among male retroperitoneal fibrosis patients. We suggest that occupational exposure to asbestos may be an important etiological factor for retroperitoneal fibrosis. Am. J. Ind. Med. 33:418–421, 1998. © 1998 Wiley-Liss, Inc.

Asbestos exposure: a potential cause of retroperitoneal fibrosis.

The etiology of retroperitoneal fibrosis is unknown in 70% of the cases. The aim of our study was to examine the possible association between occupational asbestos exposure and retroperitoneal fibrosis; only two cases have been reported in the literature. We gathered all the cases of retroperitoneal fibrosis diagnosed in the Tampere University Hospital between 1987 and 1995. We examined their hospital records to evaluate the possible etiology of the disease. We also sent a structured questionnaire to all living patients (10/13) to obtain information on their asbestos exposure. The chest radiographs of the patients were re-read to evaluate possible changes resulting from asbestos exposure. We found 13 cases of idiopathic retroperitoneal fibrosis. Seven patients (all male) had been exposed to asbestos in the past. The chest radiographs of the four most-exposed patients showed characteristic asbestos-related abnormalities, including bilateral pleural plaques, round atelectasis and small irregular lung opacities. In our study, we found that asbestos exposure and asbestos-induced changes in the lung and pleura were common among male retroperitoneal fibrosis patients. We suggest that occupational exposure to asbestos may be an important etiological factor for retroperitoneal fibrosis.

La fibrosi retroperitoneale idiopatica. Terapia medica: Idiopathic retroperitoneal fibrosis. Medical treatment

Medicai treatment of both idiopathic and secondary retroperitoneal fibrosis (RPF) aims at stopping the inflammatory process in the early stage of the disease. Glucocorticoids and non-steroidal antiestrogen drugs are used. Methylprednisolone, the most commonly used glucocorticoid, is successfully employed with different therapeutic protocols. Although based on a few cases, results of treatment with tamoxifen are also satisfactory. The authors report 25 cases of RPF, idiopathic in 14 and secondary in 11. Twelve patients underwent medical therapy, corticosteroids being used in 10 and tamoxifen in 2. All patients recovered from the fibrotic disease. Only 1 patient stopped steroid therapy due to worsening diabetes. Easy administration and the lack of side effects make tamoxifen a valid alternative to corticosteroids.

A case of retroperitoneal fibrosis combined with Sjoegren's syndrome detecting with various autoantibodies.

症例は61歳,女性.左下肢の腫脹のため入院となった.低補体,各種自己抗体陽性と共に, MRI上左内及び外腸骨動静脈周囲に軟部組織の増生と,静脈造影で側副血行路の発達を伴った左外腸骨静脈の狭窄を認めた.後腹膜線維症により左外腸骨静脈が圧迫され,左下肢の腫脹を来したものと思われた.唾液腺生検上腺房構造の消失を認め, Sjögren症候群の合併を認めた.自己免疫疾患に伴う後腹膜線維症を経験したので文献的考察を加え報告する.

Obstructive nephropathy as a result of retroperitoneal fibrosis

Retroperitoneal fibrosis is a rare disease, typically with an insidious clinical course. It is thought that this disease process is perhaps an exaggerated reaction to an inciting inflammatory event. In this study, a case of retroperitoneal fibrosis is reported, in which the patient presented with typical symptoms of retroperitoneal fibrosis, along with some atypical vasculitic symptomatology. Retroperitoneal fibrosis is a disease process with an unknown etiology, which has been observed to be associated with a number of different possible inciting factors. Two factors that have been documented in the literature as being associated with retroperitoneal fibrosis include the use of beta-blocking agents, and connective tissue disease processes such as systemic lupus erythematosus. The patient discussed was using beta-blocker medication and also had signs and symptoms suggestive of a lupus syndrome. There are no reported cases of the combined association of beta-blocker usage, lupus, and retroperitoneal fibrosis.

New medical treatments of systemic idiopathic fibrosis

Medical treatment of systemic idiopathic fibrosis is first based on steroid therapy, of which efficacy is well known for nearly 75% of cases of retroperitoneal fibrosis, but les certain for the other localisations of the disease. Studies on the immuno-pathological mechanism of systemic fibrosis have led to immunosuppressive drug use, such as azathioprin, cyclophosphamide and methotrexate. Tamoxifen has been tried because of its efficacy on desmoid tumors and seems to be of great interest. Attention is focused on fibrosing cervicitis which may also be treated with immunosuppressive drugs.

An Unusual Case of Retroperitoneal Fibrosis

With several hundred cases reported there is still much speculation about the etiology of idiopathic retroperitoneal fibrosis. We report an unusual case of retroperitoneal fibrosis with histologically identical lesion in the maxillary sinus, which has not been previously described. Both lesions showed dramatic response to corticosteroids but relapsed frequently on withdrawal of steroids, highlighting the importance of long-term follow-up.

Les médicaments bêta-bloquants sont-ils responsables de fibroses rétropéritonéales? Présentation d'une observation et revue de la littérature

The authors report a new case of retroperitoneal fibrosis due to a beta-adrenoreceptor blocking drug (atenolol) treatment. 15 well-documented cases have been described in the literature. However, the responsability of the beta-adrenoreceptor blocking drug in the occurrence of retroperitoneal fibrosis is not confirmed. Clinical cases similar to ours need to be published.

Retroperitoneal Fibrosis Following Radiotherapy for Stage I Testicular Seminoma

Retroperitoneal fibrosis, proved by surgical exploration and pathology, was discovered in a patient 13 years after 3,000 rad external beam cobalt retroperitoneal radiation therapy for stage I testicular seminoma. Ureteral obstruction resulted in the loss of 1 kidney, necessitating ipsilateral nephrectomy and contralateral ureterolysis. To my knowledge this is the first reported case of retroperitoneal fibrosis occurring after radiotherapy for testicular cancer.

Dix-sept cas de fibrose rétro-péritonéale vus en Médecine Interne

We report seventeen cases of retroperitoneal fibrosis. The aim of this study is to underline the clinical and therapeutical aspects, with a special attention to the unusual symptoms and the efficacy of corticosteroïd therapy.

Fibrose rétropéritonéale et sclérodermie. Association fortuite ou mécanisme commun ?

We present a case of retroperitoneal fibrosis associated with scleroderma (CREST syndrome). The pathogenic implications of such association with systemic vasculitis and connective tissue disease is discussed.

Intra-abdominal desmoid tumors in familial polyposis coli

A case of intra-abdominal desmoid tumors in familial polyposis coli (FPC), which regressed and disappeared by prednisolone treatment, is reported. A 37-year-old Japanese man with abdominal lumps was admitted to our hospital. He had had proctocolectomy two years before because of FPC with rectal cancer. At laparotomy, tumors were present in the abdominal wall, mesentery, and retroperitoneum. Only a small part of the tumors was resected and diagnosed microscopically to be desmoid tumors. With prednisolone administration (20 to 5 mg/day) subjective symptoms were ameliorated and desmoid tumors slowly regressed. Bilateral hydronephrosis continued and resulted in "retroperitoneal fibrosis." To our knowledge, this case is the first well-documented case of retroperitoneal fibrosis in a patient with FPC. The characteristics of the desmoid tumor in familial polyposis coli or in Gardner's syndrome and the methods for its management are discussed.

Retroperitoneal fibrosis in children (Eosinophilic and idiopathic)

Two cases of retroperitoneal fibrosis in children are presented; one was idiopathic while the other was in association with eosinophilic cystitis, heretofore not reported. A literature search of patients under eighteen years of age reviews presentation, treatment, and associated diseases.

Perivesikale Variköse und M. Ormond

Excretory urography has been the most important examination in retroperitoneal fibrosis (RPF). Medial deviation of the ureters at the level of the lower lumbar spine with hydronephrosis and dilatation of the upper part of the ureters have been considered diagnostic of RPF. Nowadays RPF can be easily recognized via CT studies, provided if appears as a mass. However, often CT studies do not detect PRF in spite of the presence of characteristic urographic changes and although RPF has been diagnosed microscopically. RPF involves the vascular system, too, and the visualization of compression or occlusion especially of the inferior vena cava or the iliac veins is also helpful in the diagnosis of RPF. In this paper we describe a case of RPF (diagnosis was confirmed histopathologically) with characteristic urographic changes, but no evidence of retroperitoneal mass. However, in this case RPF had led to a circumscribed phlebectasis of perivesical veins, which we demonstrated via CT and angiography.

Retroperitoneal barytoma

A rare case of retroperitoneal fibrosis after rectal perforation during a barium enema is reported. Pelvic cellulitis due to infiltration of barium and fecal matter is a serious complication and needs an energetic treatment. Urologic complications appear later and result from the formation of a foreign body granuloma.

Retroperitoneal fibrosis due to starch granuloma

A case of retroperitoneal fibrosis due to starch granuloma is presented. Until a new lubricant for surgical gloves is available there is a continuing hazard of starch granulomatous disease.

Value of various treatments for retroperitoneal fibrosis.

Based on retrospective analysis of 430 cases of retroperitoneal fibrosis, a classification into various etiological groups and an evaluation of the best diagnostic approach and treatment was possible. In patients presenting moderate upper urinary dilation corticosteroids alone proved to be of value in 93% of cases. Azathioprin given in combination with corticosteroids seems to be effective. The surgical 'therapy of choice' was ureterolysis with an effective intraperitoneal transposition. Ureteral restenosis after this procedure (in 22%) occurred mainly when it was not combined with long-term corticosteroid therapy. When the lower half of the ureter is involved we favor ureterolysis, its prevesical section, complete intraperitoneal transposition and a primary psoas-hitch bladder flap.

Immunofluorescence in the Study of Sclerosing Retroperitonitis

Two cases of retroperitoneal fibrosis are presented. Etiopathogenetic problems connected with various drugs are discussed, among which the methysergide is of paramount importance as well as the less known drugs such as reserpine. Histologic structures were studied by immunofluorescence which gives evidence of the antigen coloring the compound with specific gamma-globulins combined with a strongly fluorescent drug (fluorescein): its positivity is clear and precise with total anti-Ig serum, as well as with anti-IgG, less weak with anti-IgA, and negative with anti-IgM. Such results advocate a tissular immunity movement and stress the theory which aims to focus retroperitoneal fibrosis within the chapter of autoimmunization diseases.

Retroperitoneal fibrosis secondary to metastatic neoplasm

Retroperitoneal fibrosis may occur secondary to metastatic neoplasm and may simulate the features of the idiopathic variety. A case of retroperitoneal fibrosis due to gastric carcinoma is presented and the historical, physical, cystoscopic, urographic, operative, and pathologic similarities to the idiopathic form discussed. Generous biopsy of retroperitoneal plaques and careful pathologic examination are stressed to avoid missing malignant disease.

Retroperitoneal fibrosis associated with retroperitoneal abscess

A case of retroperitoneal fibrosis associated with retroperitoneal abscess is reported. The causation and treatment of idiopathic and nonidiopathic retroperitoneal fibrosis are discussed.