Retroperitoneal fibrosis as a cause of positive FDG PET/CT

Area of Science:

• Radiology
• Oncology
• Urology

Background:

• Idiopathic retroperitoneal fibrosis (IRF) is a rare condition characterized by inflammatory tissue surrounding the aorta and iliac vessels.
• Accurate diagnosis of IRF is crucial as it can mimic other malignancies, particularly on Positron Emission Tomography/Computed Tomography (PET/CT) imaging.
• Early and correct diagnosis influences treatment strategies and patient outcomes.

Observation:

• A 58-year-old man presented with intermittent abdominal, back, and scrotal pain.
• The patient underwent serial PET/CT scans for diagnostic evaluation and treatment monitoring.
• Imaging findings initially suggested a possible malignancy, necessitating a thorough differential diagnosis.

Findings:

• The case illustrates the challenges in differentiating IRF from other retroperitoneal pathologies using PET/CT.
• PET/CT findings in IRF can be variable and may overlap with those of malignant tumors.
• A comprehensive clinical and imaging review is essential to avoid misdiagnosis.

Implications:

• This case underscores the need for a high index of suspicion for IRF in patients with characteristic symptoms and imaging findings.
• Considering mimickers of IRF on PET/CT is vital for appropriate patient management and avoiding unnecessary aggressive treatments.
• Further research into specific PET/CT biomarkers for IRF could improve diagnostic accuracy.