| Autor: |
Guler-Margaritis, S. S., Baston, C., Ionescu, A. M., Hăineală, B. C., Codoiu, C., Gîngu, C., Sinescu, I. |
| Předmět: |
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| Zdroj: |
Romanian Journal of Urology; 2016, Vol. 15 Issue 3, p45-49, 5p |
| Abstrakt: |
Introduction Idiopathic retroperitoneal fibrosis (IRF) is a rare benign pathology, consisting of fibrous inflammatory tissue formation in the retroperitoneal space, surrounding main vessels and often involving nearby anatomic structures, such as the ureters, leading to obstruction and renal function impairment. Diagnosis is challenging, based upon high clinical suspicion, correct differential diagnosis and imagistic evaluation. Biopsy is required to confirm the non-malignant nature of the retroperitoneal mass. Medical immunosuppressive treatment is reasonable for moderate disease, whereas surgical treatment is indicated in advanced stage. Follow-up is mandatory but there is no consensus upon a surveillance schedule. Material and Methods We present a case of a male patient treated for a left retroperitoneal tumour destructive for the left renal unit, which was partially removed alongside the kidney, and turned up to be IRF and consequently immunosuppressive therapy was administered with 5 years normal follow-up. 8 years after the first event, IRF recurred on the right side of the retroperitoneum, obstructing the solitary kidney. Ureterolysis with omental wrapping was performed with optimal results and immunosuppressive therapy was reinitiated, with good response and normal check-ups to present day. Results and Conclusions IRF can prove to be a real challenge, as knowledge on its origin, optimal diagnostic, treatment and follow-up protocols is still building up. It is a potentially curable disease if managed correctly. Bilateral ureterolysis in unilateral disease could be taken into consideration from the start as late recurrence can occur. Follow-up should be conducted for a long period of time, maybe for the rest of the patient's life. [ABSTRACT FROM AUTHOR] |
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