Retroperitoneal fibrosis may be caused by a number of disease processes, both benign and malignant. Traditionally, open exploration and biopsy has been performed to exclude a malignant etiology prior to ureterolysis. We report a patient in whom a diagnosis of malignant retroperitoneal fibrosis was confirmed using laparoscopy. In patients in whom a metastatic etiology for retroperitoneal fibrosis is suspected, laparoscopy should be performed and representative biopsies taken. Laparoscopic techniques offer the urologist the ability to obtain an adequate tissue biopsy with a reduction in postoperative morbidity and convalescence associated with traditional laparotomy.
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