Reninoma: a rare cause of curable hypertension

Abstract

The most common type of refractory hypertension found in children is secondary hypertension, which is a potentially curable disease. Reninoma, a renin-secreting juxtaglomerular cell tumor, is a rare cause of severe hypertension that is usually diagnosed in adolescents and young adults. Surgical resection of the tumor completely cures the hypertension of patients with reninoma. The typical clinical presentation of reninoma includes hypokalemia, metabolic alkalosis, and features secondary to the increased activation of the renin-angiotensin system without renal artery stenosis. We report a case of reninoma in a female adolescent with a typical clinical presentation, in which surgical removal of the tumor completely cured hypertension. We discuss here the clinical features, imaging studies, and immunohistochemical examination of the tumor used to establish the diagnosis of reninoma and for the management of the condition.

The Small Size and Superficial Location Suggest That Laparoscopic Partial Nephrectomy Is the First Choice for the Treatment of Juxtaglomerular Cell Tumors

“…Most of the previous case reports have shown that JGCTs located in the cortical or corticomedullary location (5,12,13). However, unlike the renal cell carcinoma, some JGCTs, which were as large as more than 3 cm, could be endophytic entirely in kidney (14)(15)(16). Juxtaglomerular cells are a modified form of the smooth muscle cell, formed from a vascular component of the juxtaglomerular apparatus, and mainly located in the walls of the afferent arterioles (17).…”

“…Because of the small size of JGCTs and the popularity of laparoscopic surgery, there is a significantly increased risk of missing JGCTs during surgery. The laparoscopic ultrasound has been applied in previous cases when JGCTs were entire endophytic (14,15). In this study, four JGCTs that were endophytic and indistinguishable in NCCT received the laparoscopic ultrasound.…”

A juxtaglomerular cell tumor revealed by a hemorrhagic stroke. A case report

“…JGCT is considered as a benign tumor, but one case with pulmonary metastasis was reported. 5 Otherwise, the prognosis is especially related to the consequences of HBP, such as in our case. If no complications occurred, HBP is often asymptomatic, so that screening must systematically be done during any medical consultation.…”