Department of Respiratory Medicine, Japan Community Health Care Organization Kyushu Hospital, Japan.
Department of Radiology, Japan Community Health Care Organization Kyushu Hospital, Japan.
Intern Med. 2021 Jun 15;60(12):1907-1910. doi: 10.2169/internalmedicine.6249-20. Epub 2021 Jan 15.
A 72-year-old man presented with back pain due to a mass in the left posterior mediastinum that had surrounded and partly infiltrated the descending aorta. Mediastinal undifferentiated sarcoma was diagnosed. After the diagnosis, sudden anuria was observed. Contrast-enhanced computed tomography revealed an enhancement defect at the origins of the bilateral renal arteries. He received catheter-directed thrombolysis and was weaned off dialysis. The aspirated artery thrombus contained tumor cells, proving our diagnosis of acute kidney injury secondary to bilateral renal artery tumor embolism. In cancer patients, endovascular intervention may be a useful diagnostic and therapeutic option in cases of acute kidney injury secondary caused by peripheral thromboembolic complications.
一位 72 岁男性因左后纵隔肿块引起背痛就诊，肿块已包绕并部分浸润降主动脉。诊断为纵隔未分化肉瘤。诊断后，患者出现突发性无尿。增强 CT 显示双侧肾动脉起始处增强缺损。患者接受了导管定向溶栓治疗，并停止了透析。抽吸的动脉血栓含有肿瘤细胞，证实了我们的诊断，即双侧肾动脉肿瘤栓塞继发的急性肾损伤。在癌症患者中，血管内介入可能是继发于外周血栓栓塞并发症的急性肾损伤的一种有用的诊断和治疗选择。
