A rare case of spontaneous rupture of renal cell carcinomas

Session

Medicine and Nursing

Description

RCCs are now discovered as ‘incidentalomas’ in contrast to the classic presentation.[1] The spontaneous bleeding of the kidney (subcapsular and/or perinephric space) was first described by Carl Reinhold August Wunderlich.[2] Wunderlich syndrome is uncommon and most of the causes are benign.[3] CECT is the most reliable modality in diagnosing retroperitoneal hemorrhage and RCC.[7] After initial CT evaluation, radical nephrectomy is the treatment of choice for tumors diagnosed as malignant and embolization may be the modality of choice for benign conditions.[9,10] Material and Methods: A total of 257 patients with a total of 5 spontaneus ruptures of renal tumours were surgically treated at our hospital between May 2005 and May 2019.We describe a case , where the tumor was localized in the lower lobe of the left Kidney, with a subcapsular hemorrhage , to whom a partial nephrectomy was performed, because the total renal function was compromised. Results: In 4 cases the spontaneous ruptures were angiomyolypomas and only one case was RCC , respectively clear renal cell carcinoma . From literature we can see that the rupture of renal tumors , mainly happened in the angiomyolypomas and very rare in the RCC carcinomas. We included in our study this case, because of the rupture of RCC, as a very rare case and we decided to do partial nephrectomy, because the total renal function was compromised. Conclusions: The extensive necrosis regularly found in RCC can cause rupture of the tumour followed by subcapsular or retroperitoneal bleeding. CT findings are usually not characteristic and can mimic a simple hematoma of unknown origin. The final correct diagnosis of the renal tumor is frequently established only by the pathologist.

Keywords:

Hemorrhage, renal cell, carcinoma rupture

Session Chair

Haki Jashari

Session Co-Chair

Eglantina Kraja Bardhi

Proceedings Editor

Edmond Hajrizi

ISBN

978-9951-550-19-2

Location

Pristina, Kosovo

Start Date

26-10-2019 3:30 PM

End Date

26-10-2019 5:00 PM

DOI

10.33107/ubt-ic.2019.322

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Oct 26th, 3:30 PM Oct 26th, 5:00 PM

A rare case of spontaneous rupture of renal cell carcinomas

Pristina, Kosovo

RCCs are now discovered as ‘incidentalomas’ in contrast to the classic presentation.[1] The spontaneous bleeding of the kidney (subcapsular and/or perinephric space) was first described by Carl Reinhold August Wunderlich.[2] Wunderlich syndrome is uncommon and most of the causes are benign.[3] CECT is the most reliable modality in diagnosing retroperitoneal hemorrhage and RCC.[7] After initial CT evaluation, radical nephrectomy is the treatment of choice for tumors diagnosed as malignant and embolization may be the modality of choice for benign conditions.[9,10] Material and Methods: A total of 257 patients with a total of 5 spontaneus ruptures of renal tumours were surgically treated at our hospital between May 2005 and May 2019.We describe a case , where the tumor was localized in the lower lobe of the left Kidney, with a subcapsular hemorrhage , to whom a partial nephrectomy was performed, because the total renal function was compromised. Results: In 4 cases the spontaneous ruptures were angiomyolypomas and only one case was RCC , respectively clear renal cell carcinoma . From literature we can see that the rupture of renal tumors , mainly happened in the angiomyolypomas and very rare in the RCC carcinomas. We included in our study this case, because of the rupture of RCC, as a very rare case and we decided to do partial nephrectomy, because the total renal function was compromised. Conclusions: The extensive necrosis regularly found in RCC can cause rupture of the tumour followed by subcapsular or retroperitoneal bleeding. CT findings are usually not characteristic and can mimic a simple hematoma of unknown origin. The final correct diagnosis of the renal tumor is frequently established only by the pathologist.