Tseng Yu-Chen, Wu Seng-Tang, Chao Tai-Kuang, Wu Ching-Jiunn, Chau Tom, Yang Sung-Sen
Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec2, Cheng-gong Rd., Neihu District, Taipei, 114, Taiwan, ROC.
Int Urol Nephrol. 2014 Jun;46(6):1101-5. doi: 10.1007/s11255-013-0629-2. Epub 2013 Dec 29.
Hormonally inactive adrenocortical carcinoma (ACC) is a rare disease where abdominal discomfort and back pain are common presenting symptoms due to mass effect from a large tumor. Acute kidney injury (AKI) from retroperitoneal tumors has rarely been reported. The most common etiologies include venous thrombosis, ureteral compression, or both. Here, we described a man who presented with AKI from a large retroperitoneal tumor, which was finally diagnosed as a non-functional ACC. The inferior vena cava (IVC) was nearly completely compressed by the large retroperitoneal tumor leading to venous outflow obstruction and AKI. After surgical resection, his urine output increased and renal function recovered. Unfortunately, AKI recurred 2 months later due to recurrence of the tumor. Treatment with a tyrosine kinase inhibitor stabilized his tumor size, and hemodialysis was started. IVC-compression-associated AKI can be the presenting scenario for ACC, a rare but prognostically important aggressive neoplasm.
激素非活性肾上腺皮质癌（ACC）是一种罕见疾病，由于大肿瘤的占位效应，腹部不适和背痛是常见的首发症状。腹膜后肿瘤导致的急性肾损伤（AKI）鲜有报道。最常见的病因包括静脉血栓形成、输尿管受压或两者皆有。在此，我们描述了一名因巨大腹膜后肿瘤出现急性肾损伤的男性患者，该肿瘤最终被诊断为无功能ACC。下腔静脉（IVC）几乎完全被巨大腹膜后肿瘤压迫，导致静脉流出道梗阻和急性肾损伤。手术切除后，他的尿量增加，肾功能恢复。不幸的是，2个月后由于肿瘤复发，急性肾损伤再次出现。酪氨酸激酶抑制剂治疗使肿瘤大小稳定，随后开始进行血液透析。IVC压迫相关的急性肾损伤可能是ACC的首发表现，ACC是一种罕见但预后重要的侵袭性肿瘤。
