Complete resection of reninoma with an adequate rim of normal kidney tissue at least 0. Electron microscopy revealed renin deposits in the cytoplasm of the tumor cells, confirming the diagnosis of reninoma. As an excellent means of imaging of the renal vasculature, renal parenchyma, and adrenal glands, we recommended that CTA be considered in all cases of renin-mediated hypertension in children. The patient was in good physical health with the only past medical complaint of infrequent episodes of asthma. Surgical resection of reninoma nephron-sparing surgery is the treatment of choice and leads to normalization of blood pressure.
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. Similar articles Malignant hypertension due to a large reninoma: Adjacent glomerular vasculature acts as an internal positive control. This can be done at multiple levels of the axis by using renin inhibitors aliskiren , ACEI, angiotensin II receptor blockers ARB , or aldosterone antagonists spironolactone, eplerenone. An incomplete fibrous capsule arrow bases separates the tumor from normal kidney the upper right-hand corner. Enhanced imaging modalities and invasive renin sampling are helpful diagnostic tests leading to the correct diagnosis.
Reninoma: Case report and literature review — Johns Hopkins University
The changing face of pediatric hypertension in the era of the childhood obesity epidemic. We describe a case of reninoma and provide a review of the literature, with a discussion emphasizing the diagnostic evaluation for such patients. Hum Pathol 39 3: The surgical procedure is done either by open or, more commonly, laparoscopic approach 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 reninand typical ultrastructural finding of intracellular renin deposits 38.
J Deview 1: Following partial nephrectomy, the PRA and plasma aldosterone levels declined rapidly and the blood pressure and potassium supplementation requirements normalized. Macroscopically, the surface of the tumor is pale or purple with occasional cystic or hemorrhagic areas.
Leemingsawat C, et al. Our patient presented with hypokalemia and mild metabolic alkalosis. Demonstration of the differential hormone levels between the main renal veins and elevation above systemic hormone repport all above the upper limit of normal confirmed the left kidney tumor as a source of excessive renin production.
Reninoma: case report and literature review.
Both, the degree of hypokalemia repodt the amount of potassium excreted in urine, literatue influenced by the dietary intake of potassium.
Full relort at journal site. Recurrent hypertensive cerebral hemorrhages in a boy caused by a reninoma: Contrast imaging studies and selective venous renin sampling might be helpful in identifying the source of excessive renin production. In hypertensive patients presenting with hypokalemia and sometimes metabolic alkalosishigh aldosterone is the likely cause, guiding the investigations toward renal or adrenal causes of hypertension. The subject had persistent elevation of both plasma renin activity PRA and aldosterone.
In this paper, we describe the case of reninoma in an adolescent girl, who presented with a long history of headaches suggestive of renin-mediated hypertension. The diagnosis was confirmed by electron microscopy revealing the presence of rhomboid litdrature deposits renin crystals in the cytoplasm of the tumor cells Figure 4 D.
The surgery is well tolerated and most patients are discharged home within a few days after surgery. The tumor comprises a uniform population of round to polyhedral cells with granular, eosinophilic cytoplasm.
On light microscopy, reninomas are composed of closely packed uniform, round to polyhedral cells with granular, eosinophilic cytoplasm.
Frontiers | Reninoma: An Uncommon Cause of Renin-Mediated Hypertension | Pediatrics
Abstract Reninoma is a tumor of the renal juxtaglomerular cell apparatus that causes hypertension and hypokalemia via hypersecretion of renin. Following the confirmation of the renin-producing tumor in the left kidney, surgical resection of the repor was performed. As previously mentioned, kidney function was normal and there was no proteinuria or hematuria present. Patients with reninoma usually present with a long history of symptoms suggestive of severe hypertension, such as headaches, malaise, or failure to thrive in younger children.
Reninomas are usually small subcapsular tumors, well reeview, and mostly encapsulated.
Reninoma: Case report and literature review
Pathologic characterization of a renin-secreting juxtaglomerular cell tumor in a child and review of the pediatric literature. Am J Kidney Dis 58 4: In this paper, we present the case of reninoma in an adolescent repoort emphasizing clinical presentation, diagnostic evaluation, and medical and surgical treatment of this rare tumor.
Hypokalemia was corrected with potassium supplementation.
To confirm excessive production of renin from this tumor, renal vein renin sampling with lateralization was performed. Intern Med 52 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.
Evaluation of retroperitoneoscopic partial nephrectomy with in situ hypothermic perfusion.