TAILIEUCHUNG - Báo cáo y học: "Adrenocortical carcinoma presenting as varicocele and renal vein thrombosis: a case report."

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Adrenocortical carcinoma presenting as varicocele and renal vein thrombosis: a case report. | Cheungpasitporn et al. Journal of Medical Case Reports 2011 5 337 http content 5 1 337 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Adrenocortical carcinoma presenting as varicocele and renal vein thrombosis a case report Wisit Cheungpasitporn John M Horne and Charles B Howarth Abstract Introduction Adrenocortical carcinomas are rare aggressive tumors. Their annual incidence is approximately one to two per million among the population of the United States of America. Patients with active endocrine tumors often present with Cushing s syndrome accompanied by virilizing features. Conversely patients with nonfunctioning tumors may present with symptoms related to a mass-occupying lesion such as abdominal pain and flank pain. Although varicoceles and acute kidney injuries are common problems in medicine they are uncommon presentations of these rare tumors and easy to miss. We report a case of a large adrenocortical carcinoma that presented as testicular pain varicocele and acute kidney injury secondary to renal vein thrombosis. Case presentation A 54-year-old Caucasian man with a left-sided varicocele presented to our emergency department with lower abdominal pain and a decrease in urination. Four months previously he had noticed pain and swelling in his left groin and had been diagnosed with left-sided varicocele. For one week he began developing left-sided abdominal pain and decreased urination frequency so he came to our emergency department for evaluation. His physical examination revealed a hard mass occupying the entire left side of his abdomen crossing the midline and extending to the pelvic brim. His blood tests showed acute kidney injury and mild anemia. Computed tomography of his abdomen showed a large retroperitoneal mass on the left side displacing the left kidney inferiorly and the spleen superiorly with thoracic epidural compression. Thrombus was also identified in his left renal vein and inferior vena cava. Computed

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