Laparoscopic biopsy and ureterolysis in Erdheim-Chester disease.
Erdheim-Chester disease (ECD) is a rare, progressive, non-Langerhans cell histiocytosis that portends a poor prognosis. Misdiagnosis is common until adequate tissue analysis reveals the infiltrative histiocytic process. The disease process affects various organ systems, and effective treatment options are limited. Knowledge of the constellation of signs and symptoms associated with ECD is important to avoid misdiagnosis. We describe a patient who underwent laparoscopic bilateral ureterolysis and laparoscopic biopsy for presumed retroperitoneal fibrosis confirmed previously by percutaneous needle biopsy findings. The final pathologic diagnosis based on laparoscopic biopsy results was ECD. As evidenced by this case, ureterolysis offers little benefit to patients with ECD.
Castle
Erik P
EP
Department of Urology, Mayo Clinic College of Medicine, Scottsdale, Ariz 85259, USA.
Humphreys
Mitchell R
MR
Andrews
Paul E
PE
D001706:Biopsy; D031249:Erdheim-Chester Disease / Q000150:complications*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012185:Retroperitoneal Fibrosis / Q000150:complications / Q000473:pathology; D014517:Ureteral Obstruction / Q000150:complications / Q000473:pathology* / Q000601:surgery*