title: [Pericarditis as the initial manifestation of retroperitoneal fibrosis--a case report].
abstract: METHODS
  A 70-year-old patient with invasive ductal breast cancer underwent conserving surgery of the right breast and right axillary dissection as well as postoperative irradiation therapy. Five months later, she presented with dyspnoea and progressive weakness.
  
  
  METHODS
  Clinically, the patient showed anasarca and petechial hemorrhages, laboratory tests revealed thrombopenia, hepatic dysfunction, radiologic investigations showed enlargement of the liver and spleen, effusions of the pleura and pericardium, and ascite. Echocardiography showed pericardial effusion without cardiac tamponade.
  
  
  METHODS
  Despite supportive therapy the patient's performance status deteriorated significantly, the diagnosis of the underlying disease could not be established, the patient died with the clinical signs of cardiovascular failure. Autopsy revealed progressive retroperitoneal fibrosis with systemic involvement of pleura, pericardium, epicardium, myocardium, lungs, and kidneys and pericarditis. Retrospectively clinical symptoms were interpreted as right heart insufficiency due to pericardial effusion.
  
  
  CONCLUSIONS
  This case report reminds of occurrence of manyfold clinic manifestations of retroperitoneal fibrosis in dependence of particular organic involvement and that retroperitoneal fibrosis represents a differential diagnosis.
authors.affiliation: Ludwig Boltzmann-Institut für Angewandte Krebsforschung (LBI-ACR VIEnna), Wien.
authors.forename: Martina
authors.initials: M
authors.lastname: Baur
authors.forename: W
authors.initials: W
authors.lastname: Hulla
authors.forename: H
authors.initials: H
authors.lastname: Kienzer
authors.forename: M
authors.initials: M
authors.lastname: Klimpfinger
authors.forename: Ch
authors.initials: Ch
authors.lastname: Dittrich
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004452:Echocardiography; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D010493:Pericarditis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D010496:Pericardium / Q000473:pathology; D011183:Postoperative Complications / Q000175:diagnosis / Q000473:pathology; D018714:Radiotherapy, Adjuvant; D012185:Retroperitoneal Fibrosis / Q000175:diagnosis* / Q000473:pathology; D012187:Retroperitoneal Space / Q000473:pathology