Abstract
The patient was an 82-year-old man. He had experienced general fatigue and loss of appetite in September 1997. A hematological test showed a blood urea nitrogen level of 49mg/dl and a serum creatinine level of 5.3mg/dl. Computed tomography revealed dilatation of the bilateral renal pelvis and a ureters and a soft tissue density mass shadow around the abdominal aorta at the level of L2-L5. Retrograde pyelography showed marked stenosis of the bilateral ureters, probably due to external compression. Left nephrostomy and biopsy of retroperitoneal tissues surrounding the left ureter were performed on October 28, 1997. Under the pathological diagnosis of retroperitoneal fibrosis, we started steroid therapy. One month later, stenotic change of the left ureter improved. Six months later, we removed the left nephrostomy tube. The level of blood urea nitrogen is now 25mg/dl, and the serum creatinine level ranges from 1.3 to 1.4mg/dl.
The present patient had idiopathic retroperitoneal fibrosis associated with renal failure, and steroid therapy was effective for reduction of the lesion and improvement of the renal function.
