2015, Number 3
Carcinoma of suprarenal bark simulating a renal carcinoma. Report of a case
Language: Spanish
References: 12
Page:
PDF size: 249.54 Kb.
ABSTRACT
Background: The suprarenal cortex carcinoma has an unusual presentation and much less with the characteristics presented in this case, besides not being in the mind of the great majority of clinicians. Objective: To show a case of carcinoma of suprarenal cortex this clinically simulated a renal carcinoma with a multiple metastatic syndrome. Case presentation: A 63 year old diabetic type I and hypertensive patient, who was admitted due to abdominal pain in epigastrium and mesogaster accompanied by vomits, diarrheas, sensation of gastric fullness and loss of 10 kg of weight in the last months. Three days before his admission, it was found that he had had several episodes of diarrheas, pruritus, fever, multiple hematuria, choluria, acholia and jaundice. On physical examination it was observed that he had dehydrated mucous and paleness. Respiratory system: vesicular murmur diminished globally, isolated crepitants rale in both lung fields. Digestive system: hepatomegaly of 6 cm irregular and a tumor in left flank of 10-12 cm with lumbar contact. The analytic study showed anemia, elevated hepatic enzymes, hematuria, and rapid globular sedimentation, dehydrogenase lactate and elevated alkaline phosphatase, with imaging study which showed a metastatic process in liver, lung and ganglion with a possible renal origin. The patient died 48 hours after admission, on autopsy it was found that there was a carcinoma of suprarenal cortex which simulated a renal tumor confirmed in the histopathological study. Conclusiones: A patient with a suprarenal cortex carcinoma was admitted to a hospital simulating a renal carcinoma with clinical manifestations suggesting a renal tumoral process. This type of carcinoma is very weird and may evolve asymptomatically, showing clinical characteristics when they have a big size or it is hyperfunctioning. When facing a tumor like this of retroperitoneal location or non characteristic clinic, the doctor must bear in mind this disease.REFERENCES
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Allolio B, Fassracht M. Clinical Review. Adrenocortical carcinoma: Clinical Update. J Clin Endocrinol Metab [Internet]. 2006 Jun [cited: 2014 dec];91(6):2027-37. Available from: http://press.endocrine.org/doi/10.1210/jc.2005-2639?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
Didokan M, Bescher R, Elias E, Moor R. Natural history of adrenal cortical carcinoma. A clinic pathologic study of 42 patient. Cancer [Internet]. 1981 [cited: 2014 dec];47:2153-61.Available from: http://onlinelibrary.wiley.com/doi/10.1002/1097-0142%2819810501%2947:9%3C2153::AID-CNCR2820470908%3E3.0.CO;2-6/pdf