Dong ZY, Zhu HB. Idiopathic retroperitoneal fibrosis arising from peritoneal space: A case report and review of literature. World J Gastroenterol 2025; 31(18): 105443 [DOI: 10.3748/wjg.v31.i18.105443]
Corresponding Author of This Article
Hai-Bin Zhu, MD, Associate Chief Physician, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. 13811403328@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 14, 2025; 31(18): 105443 Published online May 14, 2025. doi: 10.3748/wjg.v31.i18.105443
Idiopathic retroperitoneal fibrosis arising from peritoneal space: A case report and review of literature
Zhen-Yu Dong, Hai-Bin Zhu
Zhen-Yu Dong, Department of Radiology, Qingdao Huangdao District People’s Hospital, Qingdao 266400, Shandong Province, China
Hai-Bin Zhu, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
Author contributions: Dong ZY and Zhu HB designed the research study and performed the research; All authors have read and approve the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Bin Zhu, MD, Associate Chief Physician, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. 13811403328@163.com
Received: January 27, 2025 Revised: March 27, 2025 Accepted: April 24, 2025 Published online: May 14, 2025 Processing time: 110 Days and 18.3 Hours
Abstract
BACKGROUND
Retroperitoneal fibrosis is a rare fibro-inflammatory condition which can be classified into idiopathic (accounting for over 75%) and secondary types (due to malignancies, infections, medications, radiotherapy or other conditions). Idiopathic retroperitoneal fibrosis (IRPF) typically affects the abdominal aorta and iliac arteries along with the surrounding retroperitoneal area. This case review aims to summarize the imaging characteristics of IRPF arising from the peritoneal space.
CASE SUMMARY
An abdominal mass was discovered in a 52-year-old man during a routine physical examination, he had not complained of abdominal pain, distension, nausea, vomiting, diarrhea, fever, and had no significant past medical or family history. Abdominal magnetic resonance imaging revealed a soft tissue mass with poorly defined margins surrounding the duodenum, exhibiting slight to moderate high signal intensity on both T1-weighted and T2-weighted images. Diffusion-weighted imaging with a β value of 800 mm²/second demonstrated slightly to moderate high signal intensity. Dynamic contrast enhanced images showed uneven enhancement on the arterial phase, with significant enhancement observed on the delayed phase. The mass infiltrated adjacent structures, including the head of the pancreas, the hepatic flexure of the colon, and part of the intestine, raising suspicion for malignant tumors such as sarcoma or lymphoma. However, surgery confirmed the diagnosis of IRPF. The patient underwent routine follow-up for one year, with no recurrence.
CONCLUSION
IRPF is a rare condition that presents considerable diagnostic challenges when lesions arise from the peritoneal space. In cases where imaging findings are atypical, a further puncture biopsy may be necessary to confirm the diagnosis.
Core Tip: This study reports an unusual case of idiopathic retroperitoneal fibrosis that was incidentally discovered on magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography imaging. The mass was primarily situated in the peritoneal cavity rather than the retroperitoneal space, encroaching upon adjacent organs such as the pancreatic head, the hepatic flexure of the colon, and part of the small intestine. The imaging diagnosis can be particularly difficult when the lesion originates in the peritoneal space, and a biopsy may be required prior to surgery.
