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CC BY 4.0 · Brazilian Journal of Oncology 2023; 19: e-20230376
DOI: 10.5935/2526-8732.20230376
Case Report
Surgical Oncology

Spontaneous perirenal hematoma - foreshadowing of an impending renal cell carcinoma - does it need close surveillance? A case report and literature review

Hematoma perirrenal espontâneo - prenúncio de um carcinoma de células renais iminente - é necessária uma vigilância rigorosa? Relatório de caso e revisão de literatura
Ankit Gupta
1   Muljibhai Patel urological hospital Nadiad Gujarat, Urology, Nadiad - Gujarat, India
,
AbhishekG Singh
1   Muljibhai Patel urological hospital Nadiad Gujarat, Urology, Nadiad - Gujarat, India
,
Ravindra Β Sabnis
1   Muljibhai Patel urological hospital Nadiad Gujarat, Urology, Nadiad - Gujarat, India
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ABSTRACT

Renal cell carcinoma classically presents as a triad of hematuria, loin pain, and a palpable mass. Sometimes it may present as an incidental finding, whereas spontaneous renal hemorrhage or Wunderlich syndrome is a rare presentation of renal cell carcinoma. We present a clinical case of 51 years old gentleman who presented with right flank pain with no other significant history. Computed tomography scan showed right perirenal hemorrhage with no abnormality in the kidney. A drain was placed and the hematoma was evacuated. The patient was discharged. On follow-up at 6 months, he was asymptomatic but found to have a renal lesion on ultrasound, which was evaluated with computed tomography scan and partial nephrectomy was done and histopathology was suggestive of papillary renal cell carcinoma. Renal cell carcinoma being an aggressive tumor, any spontaneous perirenal hemorrhage with unknown etiology mandates a strict follow-up with prompt imaging for concerns of impending renal cell carcinoma.

RESUMO

O carcinoma de células renais apresenta-se classicamente como uma tríade de hematúria, dor lombar e massa palpável. Às vezes, pode se apresentar como um achado incidental, enquanto hemorragia renal espontânea ou síndrome de Wunderlich é uma apresentação rara de carcinoma de células renais. Apresentamos o caso clínico de um senhor de 51 anos que apresentava dor no flanco direito sem outros antecedentes significativos. A tomografia computadorizada mostrou hemorragia perirrenal direita sem anormalidades no rim. Um dreno foi colocado e o hematoma foi evacuado. A paciente recebeu alta. No acompanhamento de 6 meses, ele era assintomático, mas apresentava lesão renal na ultrassonografia, que foi avaliada com tomografia computadorizada e nefrectomia parcial e a histopatologia foi sugestiva de carcinoma papilar de células renais. Sendo o carcinoma de células renais um tumor agressivo, qualquer hemorragia perirrenal espontânea com etiologia desconhecida exige um acompanhamento rigoroso com exames de imagem imediatos para preocupações do carcinoma de células renais iminente.

Keywords:

Hemorrhage - Renal cell carcinoma - Angiomyolipoma

Descritores:

Hemorragia - Carcinoma de células renais - Angiomiolipoma


Publikationsverlauf

Eingereicht: 11. Oktober 2022

Angenommen: 02. April 2023

Artikel online veröffentlicht:
15. Mai 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Ankit Gupta, AbhishekG Singh, Ravindra Β Sabnis. Spontaneous perirenal hematoma - foreshadowing of an impending renal cell carcinoma - does it need close surveillance? A case report and literature review. Brazilian Journal of Oncology 2023; 19: e-20230376.
DOI: 10.5935/2526-8732.20230376
 

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