title: Idiopathic retroperitoneal fibrosis presenting as recurrent scrotal edema: Report of a case and review of the literature.
abstract: Primary or idiopathic retroperitoneal fibrosis, first described by Ormond in 1948, is a rare and elusive diagnosis, requiring a high level of suspicion. Patients usually present with entrapment of retroperitoneal organs, the most common being the ureters, causing hydronephrosis and acute kidney injury. Here, we present the case of a 56-year-old male presenting for recurrent and intermittent scrotal edema. Upon routine laboratory workup, he was found to have an elevated creatinine level. Imaging showed encasement of bilateral ureters. Bilateral ureteral stents were placed with relief of his obstructive uropathy, followed by normalization of creatinine. The patient later underwent laparoscopic release of retroperitoneal adhesions. Biopsies taken from the operative site showed fibroblast proliferation and elements of acute and chronic inflammation. With further workup of etiologies being negative, he was diagnosed with idiopathic retroperitoneal fibrosis.
authors.forename: Rawan
authors.initials: R
authors.lastname: Saab
authors.forename: Mansour
authors.initials: M
authors.lastname: Khoury
authors.forename: Claude
authors.initials: C
authors.lastname: Afif
authors.forename: Khalil Roula
authors.initials: KR
authors.lastname: Bou
authors.forename: Chadi
authors.initials: C
authors.lastname: Bechara
authors.forename: Albert
authors.initials: A
authors.lastname: Ghaoui
authors.forename: Maroun
authors.initials: M
authors.lastname: Ghabach
authors.forename: Wajih
authors.initials: W
authors.lastname: Riakos
authors.forename: Sleiman
authors.initials: S
authors.lastname: Obeid
authors.forename: Jean
authors.initials: J
authors.lastname: Obeid
authors.forename: Georges
authors.initials: G
authors.lastname: Aftimos
authors.forename: Said
authors.initials: S
authors.lastname: Farhat
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis / Q000209:etiology*; D005832:Genital Diseases, Male / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012185:Retroperitoneal Fibrosis / Q000175:diagnosis* / Q000628:therapy; D012611:Scrotum / Q000473:pathology; D015607:Stents; D014057:Tomography, X-Ray Computed; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000628:therapy
chemical_list: D000305:Adrenal Cortex Hormones; D003404:Creatinine