表现为 Wunderlich 综合征的未分化肾细胞癌:病例报告

Saurab Karki, Mahyar Toofantabrizi
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引用次数: 0

摘要

Wunderlich 综合征是一种自发性、非外伤性、肾包膜下血肿,表现为急性侧腹疼痛、侧腹肿块和低血容量休克三联征。这种急性综合征多由肾脏恶性肿瘤引起,尤其是肾血管脂肪瘤和肾细胞癌。计算机断层扫描(CT)是诊断 Wunderlich 综合征的首选方法,其治疗方法取决于病因。在此,我们介绍一名因侧腹疼痛入院的 41 岁男性患者,他随后被发现血小板增多、血尿和低血压。计算机断层扫描发现肾脏肿块和血肿,并将其切除。肿块活检显示为未分化肾细胞癌,肿块导致恶性胸腔积液。本病例报告显示血小板计数不断升高,这引起了人们对晚期恶性肿瘤的担忧,而且三联征可能并不总是存在。报告还强调了该综合征的病因、临床表现和处理方法。
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Undifferentiated Renal Cell Carcinoma Presenting As Wunderlich Syndrome: A Case Report
Wunderlich syndrome is a spontaneous, non-traumatic, sub-capsular perinephric hematoma described by a triad of acute flank pain, the presence of flank mass, and hypovolemic shock. This acute syndrome is mostly caused by renal malignancies, particularly renal angiomyolipoma and renal cell carcinoma. Computed tomography (CT) scan is the preferred diagnostic modality for Wunderlich syndrome and its treatment depends on the cause. Herein, we present a 41- year-old male admitted with flank pain, who was subsequently found to have thrombocytosis, hematuria, and hypotension. A computed tomographic scan revealed a kidney mass and hematoma, which was removed. Biopsy of the mass revealed undifferentiated renal cell carcinoma and the mass caused malignant pleural effusion. This case report demonstrates increasing platelet counts, which raised concern for advanced malignancy and the triad of features may not always be present. It also highlights the etiology, clinical manifestation, and management of this syndrome.
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