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conferenceseries
.com
Volume 7, Issue 4(Suppl)
J Gastrointest Dig Syst, an open access journal
ISSN: 2161-069X
Gastro Congress 2017
September 11-12, 2017
September 11-12, 2017 | Paris, France
12
th
Euro-Global Gastroenterology Conference
Unique case of retroperitoneal fibrosis masking a metastatic adenocarcinoma of unknown origin
Renee Wong
St. George’s University School of Medicine, West Indies
R
etroperitoneal fibrosis secondary to malignant disease is a rare condition associated with an ominous prognosis. We present
the first reported case of retroperitoneal fibrosis related to metastatic adenocarcinoma of a primary occult tumor. This is a case
of 64-year-old Caucasian male presented to the emergency department with his third episode of anuric acute renal failure despite
bilateral ureteral stent placements and revision. A month earlier at first presentation with anuria, a CT scan revealed moderate
bilateral hydronephrosis. He had an unprovoked DVT diagnosed 3 months prior. Examination demonstrated suprapubic tenderness
and mild peripheral edema and no palpable lymphadenopathy. His creatinine was elevated at 5.42 and Hg low at 11.5mg/dL. CEA
was elevated at 220.4, with normal CA 19-9, PSA and AFP. His IgG-4 (98mg/dL), LDH, ESR and CRP were elevated. Colonoscopy
showed moderate diverticulosis of sigmoid colon with wall thickening. A F-18-FDG PET scan showed multifocal areas of metastatic
malignancy in the neck, chest, abdomen, pelvis and bones. A liver biopsy showed infiltration by malignant epithelial cells in nests,
consistent with gastrointestinal tract adenocarcinoma. Larger bilateral ureteral stents were placed and he was discharged 8 days
later with normalised creatinine. Palliative outpatient chemotherapy was commenced. This case illustrates the importance of careful
workup looking for an underlying cause of RF. Although malignancy is a relatively rare cause, its potential was highlighted by the
unprovoked DVT, weight loss and smoking. The elevated CEA and subsequent PET scan led to a diagnostic biopsy. Recognition of
this syndrome is critical in institution of appropriate therapy.
Biography
Renee Wong earned her Bachelor of Science with an Honor’s Specialization in Medical Sciences with Distinction fromWestern University, Canada, with participation
in the Scholar’s Electives Research program. She is passionate about improving medicine through research and continually attaning and sharing knowledge. She is
currently a 4th year medical student at St. Georgen’s University School of Medicine. Her recent publication includes a co-authored article “Nutrition Clinical Practice
on Low Vitamin B12 in Patients in the Amputation Rehabilitation Unit”. She is a member of the American Academy of Family Physicians.
rwong51@gmail.comRenee Wong, J Gastrointest Dig Syst 2017, 7:4(Suppl)
DOI: 10.4172/2161-069X-C1-053