Pierre S, Cordy P E, Razvi H
Division of Urology, St Joseph's Health Care, London, Ontario, Canada.
Clin Nephrol. 2002 Apr;57(4):314-9. doi: 10.5414/cnp57314.
The purpose of this case report is to document an occurrence of spontaneous resolution of idiopathic retroperitoneal fibrosis and to review the investigation and management of this unusual condition.
A detailed case summary of a patient with retroperitoneal fibrosis is presented. Current citations in Index medicus from the English-speaking literature of relevance to the topic were reviewed.
In this patient who refused open surgical intervention, bilateral stent placement allowed stabilization of renal function. CT-guided biopsy did not reveal malignancy. Serial CT imaging demonstrated gradual disappearance of the retroperitoneal mass. From the literature review, spontaneous resolution of this condition appears to be a rare phenomenon. Although often utilized, CT-guided biopsy may fail to exclude the presence of malignancy. Open surgical biopsy of the retroperitoneal mass and ureterolysis remain the standard of care for operative candidates. Establishing renal drainage and considering a trial of steroids or surveillance may be an option in carefully selected individuals.
本病例报告旨在记录特发性腹膜后纤维化的自发缓解情况,并回顾对这种罕见病症的检查与处理。
呈现了一例腹膜后纤维化患者的详细病例总结。回顾了医学索引中与该主题相关的英文文献的当前引用情况。
在这名拒绝接受开放手术干预的患者中,双侧支架置入使肾功能得以稳定。CT引导下活检未发现恶性肿瘤。系列CT成像显示腹膜后肿块逐渐消失。从文献回顾来看,这种病症的自发缓解似乎是一种罕见现象。尽管CT引导下活检常用,但可能无法排除恶性肿瘤的存在。对于适合手术的患者,腹膜后肿块的开放手术活检及输尿管松解术仍是治疗的标准方法。在经过精心挑选的个体中,建立肾脏引流并考虑试用类固醇或进行监测可能是一种选择。