Regina Djerassi, Martin Krupev, Milena Nikolova, Nikolai Naumov, Valeri Marianovski, Chavdar Elenkov, Arman Postadjian
July 10, 2008
Retroperitoneal fibrosis (RPF) is a rare disease associated with the development of chronic inflammation and fibrogenesis in the retroperitoneal space. The disease usually manifests with acute or acute over chronic renal failure and/or urosepsis. Pancreatic involvement in RPF is rare but has been described in the literature. The diagnosis of RPF is made mainly by imaging methods. Abdominal echography scan reveals the presence of an obstruction with or without inflammation; computed tomography and magnetic resonance imaging show the type and the spreading of fibrosis. Here, we report a 50-year-old female patient diagnosed with RPF during operative intervention in 2003. Initial treatment with corticosteroids and tamoxifen lead to remission. In 2007, late recurrence was observed, with tumor-like lesions over the upper, posterior, and anterior surfaces of the pancreas, spreading to intraperitoneal structures and more pronounced on the left side. Abdominal echography on day 30 showed that corticosteroid treatment lead to a decrease in the tumor-like lesions.