The radiology of juxtaglomerular tumors.

Abstract

Nine cases of proven juxtaglomerular tumor of the kidney are reviewed. Each patient presented with hypertension; elevated peripheral renin levels were found in four patients. As in past studies, this tumor occurred more frequently in women (7/9 cases). Although the patients tended to be younger (mean age, 31 years) than those with essential hypertension, all but two patients were more than 20 years of age. In all cases, the tumor was solitary, well-defined, and curable by surgery. The tumor was identified by excretory urography in 5/8 patients who underwent this procedure. A solid renal mass was detected in each of the seven patients examined by ultrasound. Since the tumor tends to be isodense with normal renal parenchyma, it is sometimes not seen on computed tomography without intravenous contrast material. Arteriography revealed a hypovascular mass in each of the nine patients. The combination of a hypovascular solid renal mass in a patient with elevated renin but no renal artery lesions should suggest the diagnosis of a juxtaglomerular cell tumor.

A Kidney Tumor in an Adolescent with Severe Hypertension and Hypokalemia: An Uncommon Case – Case Report and Review of the Literature on Reninoma

“…Renal venous sampling seems to be a reliable diagnostic tool for the lateralization of the tumor by differences of plasma renin activity of at least 1.5 [3] . A false negative may be a result of the tumor being located at the surface of the kidney, when most of the tumor blood is collected into the peripheral veins and not in the renal vein [2,[7][8][9] . In these cases the administration of angiotensinconverting enzyme inhibitors (ACE I) may help in the diagnosis by allowing the lateralization of the lesion [3] .…”

Primary renal renin secretion responding to angiotensin converting enzyme inhibition

“…Renal arteriography and enhanced CT scanning have been most useful techniques. 4 In at least five cases (including Robertson's own) the tumour was not imaged by any technique (although there are no other reports of the use of MRI) and, following nephrectomy, it has been found to be as small as 2 mm in diameter. 5 Renin secretion appears to be autonomous in about half the cases, as judged by the absence of response to posture or saline loading.…”

MR findings of renin-secreting tumor: a case report

“…Elevated renin levels can be noted in renal artery stenosis, Wilms' tumor, renal cell carcinoma, and mesoblastic nephroma [3]. Renal arteriograms differentiate renin-secreting tumors from stenosis of the renal arteries.…”

“…At least 48 well-documented cases have been reported in the English literature [1][2][3][4][5][6][7][8][9] since the first case was described in 1967 [1]. But the magnetic resonance (MR) findings of this rare disease entity have been described in only one study [9].…”