Metastasis--an unusual cause of retroperitoneal fibrosis.

Retroperitoneal fibrosis is one of the rare fibrotic processes mainly involving caudal aspect of the retroperitoneum. In up to 70% of patients no causative factor for retroperitoneal fibrosis can be identified, where it resembles auto-immune reaction. A 30-year-old lady presented with progressive oedema of the lower extremities, jaundice and abdominal swelling. Clinical examination revealed doughy abdominal feel and diffuse tenderness. Ultrasonography showed dilated intrahepatic bilary radicles and mild ascites. Contrast CT-scan showed enhancing sheath of soft tissue extending from porta down to aortic bifurcation encasing common bile duct, aorta, inferior vena cava and the ureters. CT-guided fine needle aspiration cytology revealed metastatic adenocarcinoma. Ascitic fluid did not show any malignant cell. No abdominal mass could be detected. The patient died during the course of palliative chemotherapy.