Ali Rahmo Mohamed, Omar Abdullahi Abdirahman, Ali Ismail A
Dr. Sumait Hospitals, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia.
Department of Surgery, Dr. Sumait Hospitals, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia.
Cancer Manag Res. 2025 Jul 12;17:1369-1375. doi: 10.2147/CMAR.S530092. eCollection 2025.
Renal cell carcinoma (RCC) is among the most prevalent kidney malignancies and is characterized by a variety of histological subtypes, with clear cell RCC being the most common subtype. Hypertension may occur as a paraneoplastic manifestation, although the resolution of refractory hypertension following radical nephrectomy remains an uncommon event. To our knowledge, this is the first documented case from a resource-limited setting in which refractory hypertension resolved completely following radical nephrectomy for RCC, underscoring unique diagnostic and therapeutic challenges in such environments.
A 56-year-old male presented with severe uncontrolled hypertension accompanied by persistent headaches and palpitations and was unresponsive to standard anti-hypertensive therapy. Clinical examination revealed a palpable mass in the right flank. Abdominal computed tomography revealed a large, heterogeneous mass (approximately 10 cm) occupying the hepatorenal space, which was initially suggestive of pheochromocytoma. Due to limited diagnostic resources, confirmatory biochemical testing was unavailable. The patient underwent radical nephrectomy and histopathology confirmed clear cell RCC (WHO/ISUP grade 2). The patient's hypertension resolved completely postoperatively, with subsequent follow-ups demonstrating stable blood pressure and no metastatic disease.
This case emphasizes an uncommon presentation of refractory hypertension linked directly to RCC that resolved after radical nephrectomy. This case underscores the importance of considering RCC as a differential diagnosis for refractory hypertension, particularly in resource-limited settings where advanced diagnostics and recent surgical are unavailable.
肾细胞癌（RCC）是最常见的肾脏恶性肿瘤之一，具有多种组织学亚型，其中透明细胞RCC是最常见的亚型。高血压可能作为副肿瘤表现出现，尽管根治性肾切除术后难治性高血压得到缓解的情况仍不常见。据我们所知，这是第一例来自资源有限地区的记录病例，该病例中，因RCC行根治性肾切除术后难治性高血压完全缓解，凸显了此类环境中独特的诊断和治疗挑战。
一名56岁男性因严重的难治性高血压伴持续性头痛和心悸就诊，对标准抗高血压治疗无反应。临床检查发现右侧腹部可触及肿块。腹部计算机断层扫描显示一个巨大的、不均匀的肿块（约10厘米）占据肝肾间隙，最初提示为嗜铬细胞瘤。由于诊断资源有限，无法进行确诊的生化检查。患者接受了根治性肾切除术，组织病理学证实为透明细胞RCC（WHO/ISUP 2级）。患者术后高血压完全缓解，随后的随访显示血压稳定且无转移性疾病。
该病例强调了一种与RCC直接相关的难治性高血压的罕见表现，在根治性肾切除术后得到缓解。该病例强调了将RCC作为难治性高血压鉴别诊断的重要性，特别是在无法获得先进诊断和近期手术的资源有限地区。
