title: A giant non-functional adrenocortical carcinoma presenting with acute kidney injury.
abstract: Hormonally inactive adrenocortical carcinoma (ACC) is a rare disease where abdominal discomfort and back pain are common presenting symptoms due to mass effect from a large tumor. Acute kidney injury (AKI) from retroperitoneal tumors has rarely been reported. The most common etiologies include venous thrombosis, ureteral compression, or both. Here, we described a man who presented with AKI from a large retroperitoneal tumor, which was finally diagnosed as a non-functional ACC. The inferior vena cava (IVC) was nearly completely compressed by the large retroperitoneal tumor leading to venous outflow obstruction and AKI. After surgical resection, his urine output increased and renal function recovered. Unfortunately, AKI recurred 2 months later due to recurrence of the tumor. Treatment with a tyrosine kinase inhibitor stabilized his tumor size, and hemodialysis was started. IVC-compression-associated AKI can be the presenting scenario for ACC, a rare but prognostically important aggressive neoplasm.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec2, Cheng-gong Rd., Neihu District, Taipei, 114, Taiwan, ROC.
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Tseng
authors.forename: Seng-Tang
authors.initials: ST
authors.lastname: Wu
authors.forename: Tai-Kuang
authors.initials: TK
authors.lastname: Chao
authors.forename: Ching-Jiunn
authors.initials: CJ
authors.lastname: Wu
authors.forename: Tom
authors.initials: T
authors.lastname: Chau
authors.forename: Sung-Sen
authors.initials: SS
authors.lastname: Yang
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000306:Adrenal Cortex Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D018268:Adrenocortical Carcinoma / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D014682:Vena Cava, Inferior; D014689:Venous Insufficiency / Q000209:etiology