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https://doi.org/10.21860/medflum2018_207363
Wünderlich syndrome as a first manifestation of renal cell carcinoma – case report
Frano Marinelli
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka
Dean Markić
; Katedra za Urologiju, Sveučilište u Rijeci, Medicinski fakultet, Rijeka
Sanja Štifter
; Zavod za patologiju i patološku anatomiju, Sveučilište u Rijeci, Medicinski fakultet, Rijeka
Melita Kukuljan
; Katedra za radiologiju, Sveučilište u Rijeci, Medicinski fakultet, Rijeka
Damir Miletić
orcid.org/0000-0003-2890-1890
; Katedra za radiologiju, Sveučilište u Rijeci, Medicinski fakultet, Rijeka
Abstract
Aim: To present a case with spontaneous, non-traumatic, perirenal haemorrhage (Wünderlich syndrome) as a first manifestation of renal cell carcinoma. Case report: A 37-year-old female was admitted to the emergency unit with sudden and severe pain in the left lumbar area of abdomen. She has normal voiding, without macrohaematuria or trauma in her medical history. Because of her generally instable state she was referred to emergency multi-slice computed tomography (MSCT) exam of the abdomen and pelvis which reveals inhomogeneous mass in the upper pole of the left kidney. Radiology report indicated perirenal haemorrhage most likely caused by an angiomyolipoma. The patient was operated on by urologist who performed a partial nephrectomy of the left kidney and evacuation of haematoma. Samples were taken for histopathology and cromophobe renal cell carcinoma which caused the perirenal haemorrhage was diagnosed. Our patient is controlled on regular basis, without signs of tumour recurrence. Conclusion: Wünderlich syndrome as the first manifestation of renal cell carcinoma is a very rare but life-threatening manifestation of renal cancer that warrants urgent surgery. MSCT of the abdomen and pelvis is a method of choice in haemodynamically unstable patients with acute abdominal/lumbar pain.
Keywords
abdominal pain; renal cancer; Wünderlich syndrome
Hrčak ID:
207363
URI
Publication date:
1.12.2018.
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