Laparoscopic nephro-sparing surgery of juxtaglomerular cell tumor in a child. Issue 5 (October 2016)

• Record Type: Journal Article
• Authors: Pacilli, M.; O'Brien, M.; Heloury, Y.
• Is Part Of: Journal of pediatric urology. Volume 12:Issue 5(2016)
• Page Start: 321
• Page End: 322
• Publication Date: 2016-10
• Subjects: Juxtaglomerular cell tumor -- Reninoma -- Partial nephrectomy; Pediatric urology -- Periodicals; Urologic Diseases -- Periodicals; Urogenital Diseases -- Periodicals; Urologic Surgical Procedures -- Periodicals; Child; Infant; Urologie pédiatrique -- Périodiques; Appareil urinaire -- Maladies -- Périodiques; Pédiatrie; Urologie; Pediatric urology; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); Electronic journals; Periodicals; Electronic journals; 618.926
• DOI: 10.1016/j.jpurol.2016.04.035
• Languages: English
• ISSNs: 1477-5131

Abstract

Summary: Objective: To report a case of juxtaglomerular cell tumour of the kidney (reninoma) in a child treated with laparoscopic nephron-sparing surgery. Patients and results: A 14-year-old girl was incidentally found to have hypertension (180/114 mmHg) at the time of adenotonsillectomy. Pre-operative investigations revealed a plasma renin level of 225.9 ng/dl (4.4–46), normal aldosterone, cortisol and urinary catecholamine. Abdominal ultrasound detected a 1.9 × 1.5-cm hypoechoic lesion in the right kidney lower pole; CT scan confirmed the presence of a 1.5-cm, circumscribed, solid, hypoenhancing cortical lesion in the right lower pole. Laparoscopic nephron-sparing surgery was accomplished by clamping the renal artery for 30 min; after excision, the tumour bed was closed using barbed V-loc sutures. The procedure was completed laparoscopically in 150 min with no peri-operative complications. The patient was discharged home on day 4 postoperatively. Histology confirmed the diagnosis of a juxtaglomerular cell tumour that was completely excised. The J-J stent was removed 1 month later. At follow-up, the patient's blood pressure was normalized and medications were stopped. A DMSA scan confirmed 36% residual right kidney function. Conclusion: Laparoscopic nephron-sparing surgery should be considered in children with juxtaglomerular tumours. This technique allows prompt recovery with preservation of significant renal function.