Renal adenocarcinoma presenting as a spontaneous perirenal hematoma in a patient on warfarin therapy - case report and literature review [Adenokarcinom bubrega prezentiran kao spontani perirenalni hematom kod pacijenata na terapiji warfarinom - prikaz slučaja i pregled literature]

Tomić, Miroslav and Ulamec, Monika and Trnski, Davor and Dimanovski, Jordan and Spajić, Marija and Tomas, Davor and Krušlin, Božo and Spajić, Borislav (2013) Renal adenocarcinoma presenting as a spontaneous perirenal hematoma in a patient on warfarin therapy - case report and literature review [Adenokarcinom bubrega prezentiran kao spontani perirenalni hematom kod pacijenata na terapiji warfarinom - prikaz slučaja i pregled literature]. Collegium Antropologicum, 37 (2). pp. 629-632. ISSN 0350-6134

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Abstract

We are presenting a rare case of a spontaneous extensive perirenal hematoma caused by ruptured renal adenocarcinoma in a patient who was on warfarin therapy because she had atrial fibrillation and three myocardial infarctions. A 77-year-old woman was admitted to our department with acute right flank pain and hemorrhagic shock. The anamnestic data revealed no trauma and hematuria. Abdominal ultrasonography and computed tomography scan showed large retroperitoneal hematoma. The patient underwent urgent surgery and radical nephrectomy was performed. A large retroperitoneal hematoma was found originating from a ruptured renal neoplasm in the upper pole of the right kidney. The pathohistological diagnosis was chromophobe renal cell carcinoma. The clinical, diagnostic and therapeutic peculiarities of this rare condition are presented, along with the literature review on the topic.

Abstract in Croatian

Predstavljamo rijedak slučaj spontanog i opsežnog perirenalnog hematoma uzrokovanog rupturiranim kromofobnim adenokarcinomom kod pacijentice na terapiji warfarinom zbog fibrilacije atrija i 3 preboljela infarkta miokarda. 77 godina stara žena primljena je na naš odjel s akutnim bolovima lumbalno desno i u hemoragijskom šoku. Anamneza nije otkrila traumu ili hematuriju. Abdominalni ultrazvuk i CT su pokazali veliki retroperitoenalni hematom. Pacijentica je podvrgnuta hitnom kirurškom zahvatu i učinjena je radikalna nefrektomija. Pronađen je veliki retroperitonelani hematom koji je uzrokovan rupturiranom bubrežnom neoplazmom na gornjem polu desnog bubrega. Patohistološka dijagnoza je bila kromofobni adenokarcinom bubrega. Kliničke, dijagnostičke i terapijske osobitosti ovog rijetkog slučaja su prikazane, uz pregled literature o toj temi.

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