Hypertension and unilateral renal ischemia (Page kidney) due to compression of a retroperitoneal paraganglioma.
We describe a 17-year-old hypertensive man with a left abdominal mass on the computed tomographic scan. Radiologic studies revealed a large tumor near the left renal hilus, resulting in renal compression and displacement toward the posterolateral abdominal cavity. Aortography excluded stenosis of the renal arterial vessels. Plasma and urinary catecholamines were normal and plasma renin activity (PRA) was high. The left renal vein renin was 2.1-fold higher than the right one. After resecting the tumor including the left kidney and adrenal, high blood pressure and elevated PRA returned to normal. Histologically, the tumor was a paraganglioma, and the affected kidney showed hyperplasia of the juxtaglomerular apparatus. Thus, the hypertension in our patient was probably due to renal ischemia extrinsically compressed by a non-functioning retroperitoneal paraganglioma (Page kidney).
Nakano
S
S
Division of Endocrinology, Department of Internal Medicine, Kanazawa Medical University, Ishikawa, Japan.
Kigoshi
T
T
Uchida
K
K
Morimoto
S
S
Tsugawa
R
R
Matsunou
H
H
D000293:Adolescent; D000315:Adrenalectomy; D001027:Aortography; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000209:etiology*; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology*; D007668:Kidney / Q000098:blood supply* / Q000601:surgery; D008297:Male; D009392:Nephrectomy; D010235:Paraganglioma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012186:Retroperitoneal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014567:Urography