S D Med. 2025 Dec;78(12):564-566.
ABSTRACT
Retroperitoneal fibrosis (RPF) involves an inflammatory fibrous retroperitoneal development that surrounds the abdominal aorta. Oftentimes, extension into the iliac arteries and ureters is seen, which can cause hydronephrosis and lead to renal failure. There are a variety of causes for RPF including an idiopathic presentation, complication of infection such as syphilis or tuberculosis, or a complication of autoimmune disease. A case of idiopathic retroperitoneal fibrosis in a 73-year-old male will be examined. The patient presented with bilateral flank pain, hematuria, and low urine output that had lasted for about 4 days. Initial laboratory workup had shown increased levels of BUN at 49 mg/dL, CRP at 61.6 mg/L, and creatinine at 6.28 mg/dL. A 5.1 cm abdominal aortic aneurysm extending into the bilateral common iliac arteries was seen on CTA of the abdomen and pelvis. Surrounding the aneurysm was a soft tissue mass that had extension into the ureters bilaterally and caused hydronephrosis. Rheumatological and infectious workup of the soft tissue mass was negative. Vascular surgery performed endovascular aneurysm repair and urology performed bilateral cystoscopy and placed ureteral stents. High dose steroids were prescribed for a month. On follow up, CTA imaging showed a reduction of the mass as well as return of inflammatory markers to baseline.
PMID:42485369