To preserve as much normal functional nephron mass as possible, nephron-sparing surgery in the form of partial nephrectomy, wedge excision, or even tumor enucleation are all possible alternatives to complete nephrectomy for reninomas. Hypertensive crisis in children. The correct diagnosis is based on the combination of macroscopic appearance of the tumor, light microscopy of the tumor cells, immunohistochemical staining for various cell markers including renin , and typical ultrastructural finding of intracellular renin deposits 3 , 8. Similar articles Malignant hypertension due to a large reninoma: Hypertension was diagnosed only after several office visits.
The specimen was retrieved inside an endocatch bag as to not contaminate the abdominal wall. We will be provided with an authorization token please note: The vessels were dissected and clamped. Case report and literature review. Medical imaging looking for more common causes of renin-mediated hypertension, such as renovascular or renal parenchymal disease, might miss these small tumors. A laparoscopic transperitoneal approach, with mobilization and reflection of the splenic flexure, allowed exposure of the anterior surface of the left kidney. Clin Transl Oncol 14 5:
The tumor cells were uniform with round nuclei and eosinophilic granular cytoplasm Figure rennoma B. Intern Med 52 Some studies suggest that the possible oncogene s or tumor suppressor gene s may be localized on chromosome 4 and 10, or chromosome 9 and 11, respectively 325 Our patient presented with long-standing headaches, followed by the development of lethargy, and polyuria with polydipsia.
They are typically diagnosed in adolescents and young adults with occasional cases reported in younger children 6 — 9. They all contributed to the writing of this manuscript and its revision.
Abstract Reninoma is a tumor of the renal juxtaglomerular cell apparatus that causes hypertension and hypokalemia via hypersecretion of renin.
Reninomas are usually small subcapsular tumors, well circumscribed, and mostly encapsulated. Formal renal angiography, though not specifically indicated in cases of reninoma, is often performed in cases of suspected RAS and in cases likely requiring radiological intervention such as balloon angioplasty or pre-operative tumor embolization. The procedure was done under general anesthetic and ultrasonographic literaturee.
Elevated blood levels of renin and aldosterone confirm the clinical suspicion of renin-mediated hypertension. Even when hypertension is diagnosed, literaature identification of reninoma can be challenging.
Reninoma: case report and literature review. – Semantic Scholar
The diagnosis repogt reninoma should be considered in patients presenting with severe hypertension, hyperreninemia, hyperaldosteronism, and hypokalemia in whom renovascular and renal parenchymal disease have been excluded. Metastatic juxtaglomerular cell tumor in a year-old man. Whether these patients eventually become normotensive is difficult to predict given no reports on long-term follow-up.
A diurnal rhythm in plasma renin activity in man. Because of the association of long-standing severe hypertension and hypokalemia, our further work-up focused on the causes of renin-mediated hypertension. You can login by using one of your existing accounts. Pediatric case of the day.
The tumor cells are characterized by uniform non-enlarged nuclei and a cytoplasm shows numerous pleiomorphic rounded, polygonal, and rhomboidal dense deposits, consistent with renin crystals. As a consequence of this hormonal activation, patients develop severe hypertension, potassium wasting, and hypokalemia.
Hypertension was diagnosed only after several office visits. Case report, review of the literature and possibility for organ preserving operation].
Link to citation list in Scopus. J Clin Invest 45 Imaging of renin-mediated hypertension in children.
Warm ischemic times are usually less than 30 min with no cases of acute kidney injury reported in the literature. We present our approach to diagnostic evaluation of this patient that led us to the correct diagnosis of reninoma, and discuss the medical management and surgical treatment of this rare tumor.
Case report and literature review ‘ Journal of Reoprtvol. Leemingsawat C, et al. The production of renin and aldosterone can be influenced by many factors, including the state of hydration, dietary intake of salts, postural changes, and medications Am J Clin Pathol 6: Clin Exp Hypertens 15 2: Pediatr Blood Cancer revlew 2: Renal vein renin sampling with lateralization.
Reninomas are a rare but curable cause of secondary hypertension.