Differential Diagnosis: Retroperitoneal Fibrosis and Oncological Diseases

Abstract

Retroperitoneal fibrosis is a connective disease of the auto-inflammatory/auto-immune type of the retroperitoneum with unknown etiology and pathological mechanism. The manifestations of the pathology can be local or systemic. Amongst the local symptoms, the dull and constant pain in the hips, back or abdomen is the most frequent. We report here a case of a 47-year-old woman, whose pathogenic mechanism could be related to an "IgG4-related disease" disorder as suggested by an increased serum level of this subclass of IgG and the positive immunohistochemistry. The diagnosis is not easy, because this pathology generates masses; adenomegalies with retro peritoneal development, that makes it similar to lymphomas or metastases from ovarian tumors.

Keywords: Lymphomas; Oncological disease; Retroperitoneal fibrosis.

Figure. 1

Abdomen- Pelvic MRI . Fibrotic abnormalities, with prevalence lamellar, that branch off on the right from the vaginal hemicupole, from which they reach the right ureter in the pre-bladder tract adhering to the posterior wall of the sigma 1 A - Axial T2 weighted FSE 4mm 1 B - Coronal T2 weighted FSE 4mm