Medicina, Vol. 59 No. 2, 2023.
Studija slučaja
https://doi.org/10.21860/medflum2023_300580
Wunderlich Syndrome as the First Manifestation of Kidney Cancer: A Case Report
Paula Radoš
orcid.org/0009-0003-0953-958X
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
Dean Markić
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
Sažetak
Aim: To present a case in which a malignant neoplasm of the kidney is the cause of Wunderlich syndrome and point out the importance of recognizing this syndrome in clinical practice. Case report: A male patient came to the emergency unit with pain in his left hemiabdomen, nausea, dizziness, and a darker stool. Physical examination did not reveal any pathological findings, but ultrasound examination revealed a more abundant perirenal collection. A detailed examination and CT finding revealed a mass on the upper pole of the left kidney as well as a more extensive perirenal hematoma. The urgent nephrectomy was performed and pathohistological findings confirmed that it was renal cell carcinoma (clear cell subtype). Two years later, the patient reappeared in the emergency department of the hospital due to severe paraparesis. After physical examination, the patient was sent for magnetic resonance imaging, which showed secondary pathological remodeling at several levels of the thoracic spine and the spread of the pathological process in the spinal canal. The patient then underwent laminectomy with reduction of the tumor in the spinal canal and the sample was sent for pathohistological analysis. Immunohistochemical staining confirmed renal cell carcinoma metastases. The patient was then sent for further oncological treatment. Conclusion: Wunderlich syndrome has an extremely rare occurrence in urological practice but should be included in the differential diagnosis in patients presenting with lumbar pain, palpable mass and signs of shock. This syndrome is most frequently associated with benign renal neoplasms, but, as in our patient, may be associated with malignant tumors.
Ključne riječi
Angiomyolipoma; Carcinoma, Renal Cell; Shock
Hrčak ID:
300580
URI
Datum izdavanja:
1.6.2023.
Posjeta: 510 *