Secondary hypertension due to juxtaglomerular cell tumour (reninoma)

Nunes, Igor; Santos, Tiago; Croca, Sara; Figueira, Alberto; Coutinho, João; Carvalho, L.; Nogueira, J. Braz

doi:10.1016/j.jash.2015.03.275

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“…The plasma renin level is significantly increased in laboratory examinations. Therefore, when the plasma renin level increases, the possibility of reninoma should be considered [11]. Although there are reports of renal vein invasion and lung metastasis 5 years later [12], the vast majority of reninomas are benign, and surgical resection is currently considered standard of care [13,14].…”

Section: Discussionmentioning

confidence: 99%

Clinical Application of Ultrasound in the Diagnosis and Treatment of Reninoma

Li¹,

Zhang²,

Song³

et al. 2020

Advanced Ultrasound in Diagnosis and Therapy

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To investigate the clinical value of ultrasound in the diagnosis and treatment of reninoma. Methods:We retrospectively analyzed the ultrasound findings of 9 patients with reninoma confirmed by pathology after surgical resection in our hospital between September 2012 and August 2019. All patients underwent conventional preoperative ultrasonography. Three underwent contrast-enhanced ultrasound (CEUS) and 3 with complete endogenetic tumor underwent intraoperative ultrasonography.Results: Of the 9 patients with conventional ultrasound, 7 had renal space-occupying lesions and 2 had missed diagnosis. A hypoechoic or hyperechoic solid mass with regular morphology, clear boundary, capsule, weak echo halo around the mass, incomplete thin strip color blood flow signal around the mass were shown in 7 cases. Color Doppler displayed color flow signal of the incomplete thin strip around the mass and arterial blood supply with an internal thin branch. In 3 patients (including 2 with missing diagnosis by conventional ultrasound) who underwent preoperative contrast-enhanced ultrasound, the reninoma manifested as low enhancement, and the perfusion pattern showed as slow wash-in and slow wash-out compared with normal renal cortex. In 3 patients (including 2 cases of missed diagnosis by conventional ultrasound) with completely endogenic reninoma, intraoperative ultrasound clearly showed the tumor characteristics, and all successfully underwent laparoscopic ultrasound-guided partial nephrectomy. Conclusions:Preoperative conventional ultrasound combined with CEUS, and clinical features, are helpful for the qualitative diagnosis of reninoma. Laparoscopic partial resection is the first-choice treatment for reninoma. Intraoperative ultrasound can provide real-time imaging, accurately evaluate the tumor status, and provide important information for surgeons.

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Section: Discussionmentioning

confidence: 99%