Transduodenal EUS FNA Diagnosis of Idiopathic Retroperitoneal Fibrosis

Chira, Romeo; Dragomir, Irina; Ichim, Vlad Andrei; Bințințan, Vasile

doi:10.15403/jgld-524

Cited by 2 publications

(2 citation statements)

References 4 publications

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“…Lastly, our patient also developed a possibly IgG4-related cholangitis and peritoneal fibrosis during treatment. However, this latter diagnosis was not supported by histology since the risk of bleeding related to the sampling of peritoneal fibrosis was unbalanced regarding the benefits, even with an EUS approach [27]. Moreover, data from a previous series [28] of retroperitoneal fibrosis patients showing that inflammatory retroperitoneal fibrosis is frequently not extended below the aortic bifurcation and causing medial ureteral attraction, similar to our case, also supported our decision not to attempt any sampling.…”

Section: Discussionmentioning

confidence: 43%

Complete Remission of Advanced Hepatocellular Carcinoma Treated with Sorafenib and Concomitant Appearance of IgG4- related Diseases. A Case Report

Impellizzeri

Renzulli

Azzaroli

et al. 2020

JGLD

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Sorafenib is currently the gold standard therapy for palliative treatment of advanced hepatocellular carcinoma (HCC) in patients with compensated liver disease. There are few cases reported in literature describing patients with HCC achieving a complete remission (CR) due to Sorafenib therapy. We report the case of a 62-year old patient who obtained CR despite single, long drug discontinuation and kept it without any maintenance therapy. Furthermore, this is the first case describing the onset of a likely IgG4-related retroperitoneal fibrosis and cholangitis during Sorafenib administration. Further studies are required to define the predictors of a good response to Sorafenib and to codify a therapeutic maintenance regimen for patients who achieve CR.

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Section: Discussionmentioning

confidence: 43%

Complete Remission of Advanced Hepatocellular Carcinoma Treated with Sorafenib and Concomitant Appearance of IgG4- related Diseases. A Case Report

Impellizzeri

Renzulli

Azzaroli

et al. 2020

JGLD

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“…However, we herein showed that the endoscopic arena is likely to also play a significant role in this setting, which could be even preferred over other modalities. Although isolated reports, that share our positive experiences, exist [17,18,19], EUS-FNA/FNB as a modality for diagnosing RPF has attracted surprisingly little attention in the literature. ▶ Table 1 provides an overview over previously published case reports that demonstrated the use of EUS-FNA/FNB to successfully diagnose RPF.…”

Section: Discussionmentioning

confidence: 99%

Role of transduodenal endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) for diagnosis of retroperitoneal fibrosis (Ormond’s disease)

2023

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Background Retroperitoneal fibrosis (RPF), often referred to as Ormond’s disease when it is of idiopathic origin, is a rare disease characterized by the presence of inflammatory infiltrates and periaortic masses in the retroperitoneum. For a definite diagnosis, a biopsy and subsequent pathological examination is required. Currently accepted methods for retroperitoneal biopsy include open, laparoscopic, or CT-guided approaches. However, transduodenal endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) for diagnosis of RPF has attracted only little attention in the literature. Case Reports We report two male patient cases who presented with leukocytosis, elevated C-reactive protein, and a suspicious retroperitoneal mass of unknown origin on computed tomography. One patient also reported left lower quadrant pain, whereas the other patient suffered from back pain and weight loss. In both patients, idiopathic RPF was successfully diagnosed by using transduodenal EUS-FNA/FNB with 22- and 20-gauge aspiration needles. Histopathology revealed dense lymphocytic infiltrates and fibrosis. The procedures lasted approximately 25 and 20 minutes, respectively, and in both patients no serious adverse events occurred. Treatment included steroid therapy and administration of Azathioprine. Conclusion We demonstrate that using EUS-FNA/FNB to diagnose RPF is a feasible, fast, and safe method, which should always be considered as a first-line diagnostic modality. Hence, this case report emphasizes that gastrointestinal endoscopists are likely to play an important role in the setting of suspected RPF.

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Transduodenal EUS FNA Diagnosis of Idiopathic Retroperitoneal Fibrosis

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Cited by 2 publications

References 4 publications

Complete Remission of Advanced Hepatocellular Carcinoma Treated with Sorafenib and Concomitant Appearance of IgG4- related Diseases. A Case Report

Complete Remission of Advanced Hepatocellular Carcinoma Treated with Sorafenib and Concomitant Appearance of IgG4- related Diseases. A Case Report

Role of transduodenal endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) for diagnosis of retroperitoneal fibrosis (Ormond’s disease)

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