Presentation with bilateral hydronephrosis and impaired renal function.
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Contrast administered using the bilateral nephrostomy catheters (no intravenous contrast due to impaired renal function). Retropertineal mass surrounding, but not displacing, the abdominal aorta and part of the inferior vena cava with possible medialisation of the ureters due to fibrotic traction. At the location of the mass there is ureteral stenosis on the right and occlusion of the left ureter.
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Ultrasound examination by urologist showed bilateral hydronephrosis leading to a request for nephrostomy placement by interventional radiologist on one side followed by the contralateral side 2 days later.
Follow-up CT showed an obstructing mass surround the aorta, which was not displaced anteriorly by the mass. Together with possible medialisation of the ureters due to traction this is typical of retroperitoneal fibrosis.