Publicação
Massa localizada no pólo superior do rim : caso clínico de um diagnóstico a não esquecer
| Resumo: | Masses located in the upper pole of the kidney can be a real diagnostic challenge. If, on one hand, it can mean neoplasic pathology of the kidney, on the other hand can be the sign of adrenal tumour or mestastasis. Particular clinical, hormonal and imagiological findings can identify specific entities, however almost always it is up to the Pathology to assure a definitive diagnosis. It is presented a case report of a 61 years old woman who performed an abdominal ecography in the clinical context of diffuse epigastric pain, in which we detect a nodular masse with 6,2x5,4 cm between the adrenal and left kidney. On CT scan we found imagiological features highly suggestive of malignant pathology. After radical nephrectomy with homolateral adrenalectomy, the patient developed acute primary adrenal insufficiency, which was a sign of primitive pathology of the adrenal gland. Adrenocortical carcinoma was the pathologic diagnosis, a rare and aggressive cancer (the patient passed away 4 months after the surgery). This case report underscores that the malignant pathology of the adrenal gland is rare, but it is not inexistent, so its search is essential. |
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| Autores principais: | Tavares, Tércio |
| Assunto: | Anatomia patológica Rim |
| Ano: | 2014 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | português |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Masses located in the upper pole of the kidney can be a real diagnostic challenge. If, on one hand, it can mean neoplasic pathology of the kidney, on the other hand can be the sign of adrenal tumour or mestastasis. Particular clinical, hormonal and imagiological findings can identify specific entities, however almost always it is up to the Pathology to assure a definitive diagnosis. It is presented a case report of a 61 years old woman who performed an abdominal ecography in the clinical context of diffuse epigastric pain, in which we detect a nodular masse with 6,2x5,4 cm between the adrenal and left kidney. On CT scan we found imagiological features highly suggestive of malignant pathology. After radical nephrectomy with homolateral adrenalectomy, the patient developed acute primary adrenal insufficiency, which was a sign of primitive pathology of the adrenal gland. Adrenocortical carcinoma was the pathologic diagnosis, a rare and aggressive cancer (the patient passed away 4 months after the surgery). This case report underscores that the malignant pathology of the adrenal gland is rare, but it is not inexistent, so its search is essential. |
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