Sakata Ryoko, Shimoyamada Hiroaki, Yanagisawa Masahiro, Murakami Takayuki, Makiyama Kazuhide, Nakaigawa Noboru, Inayama Yoshiaki, Ohashi Kenichi, Nagashima Yoji, Yao Masahiro, Kubota Yoshinobu
Department of Urology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Case Rep Pathol. 2013;2013:973865. doi: 10.1155/2013/973865. Epub 2013 Mar 27.
The juxtaglomerular cell tumor (JGCT) is a rare renal tumor characterized by excessive renin secretion causing intractable hypertension and hypokalemia. However, asymptomatic nonfunctioning JGCT is extremely rare. Here, we report a case of nonfunctioning JGCT in a 31-year-old woman. The patient presented with a left renal tumor without hypertension or hypokalemia. Under a clinical diagnosis of renal cell carcinoma, radical nephrectomy was performed. The tumor was located in the middle portion adjacent to the renal pelvis, measuring 2 cm in size. Pathologically, the tumor was composed of cuboidal cells forming a solid arrangement, immunohistochemically positive for renin. Based on these findings, the tumor was diagnosed as JGCT. In cases with hyperreninism, preoperative diagnosis of JGCT is straightforward but difficult in nonfunctioning case. Generally, JGCT presents a benign biological behavior. Therefore, we should take nonfunctioning JGCT into the differential diagnoses for renal tumors, especially in younger patients to avoid excessive surgery.
肾素瘤是一种罕见的肾肿瘤,其特征是肾素分泌过多,导致顽固性高血压和低钾血症。然而,无症状无功能的肾素瘤极为罕见。在此,我们报告一例31岁女性的无功能肾素瘤病例。该患者表现为左肾肿瘤,无高血压或低钾血症。在临床诊断为肾细胞癌的情况下,进行了根治性肾切除术。肿瘤位于肾盂附近的中部,大小为2厘米。病理上,肿瘤由立方形细胞组成,呈实性排列,肾素免疫组化阳性。基于这些发现,该肿瘤被诊断为肾素瘤。在高肾素血症的病例中,肾素瘤的术前诊断很简单,但在无功能的病例中则很困难。一般来说,肾素瘤表现出良性生物学行为。因此,我们应将无功能肾素瘤纳入肾肿瘤的鉴别诊断中,尤其是在年轻患者中,以避免过度手术。