Jan F, Roussel L, Lassailly R, Chopin D, Rahmouni A, Levy E, Cachin J C
Fédération de Cardiologie, Hôpital Henri Mondor, Créteil.
Presse Med. 1999 Apr 24;28(16):841-4.
The etiologic work-up of hypertension with hyperaldosteronism and elevated serum renin includes search for renal artery stenosis. Intrinsic stenosis is a common finding, but hypertension secondary to extrinsic compression of the renal artery is exceptional.
A 48-year-old woman with an uneventful history was hospitalized for recent onset hypertension. Laboratory tests showed hypokaliemia, and elevated aldosterone and renin. Duplex Doppler exploration of the renal vessels evidenced extrinsic compression of the left renal artery by a tumoral mass found to be a nodal metastasis at surgery. Pathology reported cancer of the ovary. Blood pressure, and aldosterone and renin levels returned to normal after complete tumor resection. No antihypertensive treatment was required.
This is undoubtedly the first case of metastatic cancer of the ovary revealed by hypertension; it can be added to the list of 49 other published cases of extrinsic compression of the renal artery by various causes leading to hypertension. In most cases, surgical removal of the obstacle or nephrectomy provided cure of the hypertension.
对于伴有醛固酮增多症和血清肾素升高的高血压患者进行病因检查时，需排查肾动脉狭窄。肾实质狭窄是常见发现，但肾动脉外部受压继发的高血压则较为罕见。
一名既往病史无异常的48岁女性因近期出现高血压而住院。实验室检查显示低钾血症，醛固酮和肾素水平升高。肾脏血管的双功多普勒检查证实左肾动脉被一个肿瘤块外部压迫，手术中发现该肿瘤块为淋巴结转移瘤。病理报告为卵巢癌。肿瘤完全切除后，血压、醛固酮和肾素水平恢复正常。无需进行降压治疗。
这无疑是首例由高血压揭示的卵巢转移性癌病例；它可被列入其他49例因各种原因导致肾动脉外部受压进而引发高血压的已发表病例之中。在大多数情况下，手术移除障碍物或进行肾切除术可治愈高血压。
