Spinal cord compression: an unusual clinical manifestation of retroperitoneal fibrosis

Retroperitoneal fibrosis is a rare disorder consisted of a periaortic fibrous mass that compresses retroperitoneal organs. We report a case of retroperitoneal fibrosis diagnosed after a spinal cord compression. Magnetic resonance imaging scan showed a prevertebral mass which affected a vertebral body. It extended to the epidural space and compressed the spinal cord. The final diagnosis was established through the mass biopsy by means of mediastinoscopy. After prednisone treatment, both clinical remission and mass reduction in the follow-up MRI were observed. The spinal cord compression is an extremely unusual initial manifestation of retroperitoneal fibrosis. Nevertheless, it should be considered in the differential diagnosis of spinal cord compression syndrome, specially given the possibility of its medical treatment instead of aggressive surgical treatment.