Preoperative Diagnosis of Juxtaglomerular Cell Tumors in Eight Patients

Kang, Shan; Chen, Fang; Zhong, Yan; Han, Bingchao; Cheng, Guanghe; Guo, Aitao; Tian, Yuan; Tong, Xinyuan; Dou, Jingtao; Ye, Huiyi

doi:10.1111/jch.12810

Cited by 5 publications

(3 citation statements)

References 31 publications

(48 reference statements)

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“…JGCT-induced hypertension often requires the combined use of multiple antihypertensive drugs, mainly angiotensin converting enzyme inhibitors, to effectively control blood pressure[ 11 ]. In addition, a secondary increase in aldosterone boosts urinary potassium excretion by promoting exchange of sodium and potassium in the collecting duct of the main cells, leading to hypokalemia, which may lead to limb weakness and other corresponding symptoms[ 12 ]. A 24-h urine potassium test is helpful in detecting secondary aldosteronism during the course of the disease.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy complicated by juxtaglomerular cell tumor of the kidney: A case report

Fu¹,

Deng²,

Wang³

et al. 2023

World J Clin Cases

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BACKGROUND Juxtaglomerular cell tumor (JGCT) of the kidney, also known as reninoma, is a rare renal tumor that typically clinically manifests as hypertension, hypokalemia, high renin, and high aldosterone. It is a cause of secondary hypertension. Pregnancy with JGCT is rarer and easily misdiagnosed as pregnancy-induced hypertension, thus affecting treatment. CASE SUMMARY A 28-year-old woman presented in early pregnancy with hypertension (blood pressure of 229/159 mmHg), nausea, and occasional dizziness and headache. The patient was diagnosed with pregnancy-induced hypertension, and no relief was found after symptomatic treatment; hence, the pregnancy was terminated by artificial abortion. Her blood pressure remained high following termination of pregnancy. Blood tests suggested hypokalemia (2.997 mmol/L), blood aldosterone measured 613 ng/L, and computed tomography urography showed a tumor in the right kidney. Therefore, laparoscopic partial nephrectomy was performed. After surgery, the patient’s blood pressure returned to normal, and blood potassium, aldosterone, and renin normalized. Postoperative pathological examination revealed JGCT. After long-term follow-up, the patient became pregnant again 6 mo after surgery. No hypertension occurred during pregnancy, and the patient delivered a healthy female neonate. CONCLUSION Patients with pregnancy complicated by JGCT are difficult to diagnose. Herein, we advise surgeons on proper handling of such situations.

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Section: Discussionmentioning

confidence: 99%

Pregnancy complicated by juxtaglomerular cell tumor of the kidney: A case report

Fu¹,

Deng²,

Wang³

et al. 2023

World J Clin Cases

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“…Since PET/CT could not be utilized to differentiate between renal cell carcinomas and JGCT (either functioning or nonfunctioning), clinicians have tried to explore other indicators which might help. First, Kang et al [ 10 ] pointed out that age could be a useful indicator: comparing JGCT and renal cell carcinoma (RCC), the probability of developing JGCT in the 14 to 30 years’ age group was higher than that of developing RCC ( P = .0000). While for advancing age, the probability of developing JGCT became lower than that of developing RCC.…”

Section: Discussionmentioning

confidence: 99%

Case report: a nonfunctioning juxtaglomerular cell tumor mimicking renal cell carcinoma

Dong

Xu²,

Ji³

2020

Medicine

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Introduction: Based on existing literature, the juxtaglomerular cell tumor (JGCT) is a rare renal tumor, typically present with hypertension and hypokalemia. Nonfunctioning JGCT, without hypertension or hypokalemia, is extremely rare. Patient Concerns: Herein, we report a case of nonfunctioning JGCT mimicking renal cell carcinoma. The 29-year-old woman with an unremarkable past medical history presented with a left renal tumor without hypertension or hypokalemia. Diagnosis: Both CT and 18F-FDG-PET/CT suggested a malignancy, possibly renal cell carcinoma. Interventions: The tumor was then removed completely via robotic assistant laparoscopic partial nephrectomy; and pathology result was JGCT. Since the patient had no hypertension or hypokalemia, a nonfunctional JGCT was diagnosed. Outcomes: The patient recovered uneventfully, and was in good health in 6-months’ follow-up period. Conclusion: Preoperative identification of JGCT is very difficult due to the lack of specific clinical manifestations. This case teaches us that for young patients with renal tumors whose CT enhancement is not obvious at the early phase, JGCT should be considered as a differential diagnosis. Radical nephrectomy should be avoided for JGCT in consideration of its relatively good prognosis.

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“…Furthermore, as a solid kidney mass, reninoma needs to be differentiated from malignant renal tumors. Kang et al compared the MRI features of 8 reninoma cases (overlapping with 8 cases in this study) with those of 27 clear cell renal cell carcinoma (ccRCC) cases, and emphasized the usefulness of MRI in distinguishing reninoma from other renal tumors [18].…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Surgery-Based Multidisciplinary Clinical Management of Reninoma: A Single-Center Study

Liu

Wang

et al. 2019

Med Sci Monit

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Background This article presents our experience in managing a rare kidney tumor – reninoma – by analyzing a relatively large series of cases from a single center. Material/Methods Nine cases of reninoma were reviewed. Clinical manifestations, imaging examinations, laboratory examinations, perioperative data, and pathological findings were summarized. A 58.8-month follow-up was performed to evaluate patient survival and recrudescence. Results The main clinical manifestations were hypertension, hypokalemia, headache, dizziness, nausea, vomiting, palpation, and sweating. Three patients had hypertensive end-organ damage, including brain hemorrhage, gestation termination, and grade III ocular fundus changes. All patients underwent retroperitoneal laparoscopic partial nephrectomy successfully. The mean warm ischemic time was 23.4 min. The median operation time was 95.1 min, with a median estimated blood loss of 60 ml. The median hospital stay was 6 days. No serious intraoperative or postoperative complications occurred. The histology and electron microscopy findings confirmed the diagnosis of reninoma in all cases. After 58.8 months of follow-up, symptoms involving hypertension were relieved in all patients, and no tumor recurrence or metastasis was detected. Conclusions Reninoma may have severe consequences despite being a benign tumor. Retroperitoneal laparoscopic partial nephrectomy is a feasible and effective method for the surgical removal of reninoma. Multidisciplinary cooperation plays an important role in improving the diagnosis and enabling the early surgical treatment of reninoma. Especially in cases of reninoma with moderate and high RENAL scores, an accurate diagnosis of reninoma based on multidisciplinary cooperation facilitates the selection of less invasive surgical approaches.

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Preoperative Diagnosis of Juxtaglomerular Cell Tumors in Eight Patients

Cited by 5 publications

References 31 publications

Pregnancy complicated by juxtaglomerular cell tumor of the kidney: A case report

Pregnancy complicated by juxtaglomerular cell tumor of the kidney: A case report

Case report: a nonfunctioning juxtaglomerular cell tumor mimicking renal cell carcinoma

Minimally Invasive Surgery-Based Multidisciplinary Clinical Management of Reninoma: A Single-Center Study

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