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Scientific paper - Case study
Wunderlichov sindrom kao prva manifestacija karcinoma bubrega: prikaz slučaja
Medicina Fluminensis, 59 (2023), 2; 200-203. https://doi.org/10.21860/medflum2023_300580
Radoš, Paula; Markić, Dean

Institutional repository: Repository of the University of Rijeka, Faculty of Medicine

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Radoš, P. & Markić, D. (2023). Wunderlichov sindrom kao prva manifestacija karcinoma bubrega: prikaz slučaja. Medicina Fluminensis, 59. (2), 200-203. doi: 10.21860/medflum2023_300580

Radoš, Paula and Dean Markić. "Wunderlichov sindrom kao prva manifestacija karcinoma bubrega: prikaz slučaja." Medicina Fluminensis, vol. 59, no. 2, 2023, pp. 200-203. https://doi.org/10.21860/medflum2023_300580

Radoš, Paula and Dean Markić. "Wunderlichov sindrom kao prva manifestacija karcinoma bubrega: prikaz slučaja." Medicina Fluminensis 59, no. 2 (2023): 200-203. https://doi.org/10.21860/medflum2023_300580

Radoš, P. and Markić, D. (2023) 'Wunderlichov sindrom kao prva manifestacija karcinoma bubrega: prikaz slučaja', Medicina Fluminensis, 59(2), pp. 200-203. doi: 10.21860/medflum2023_300580

Radoš P, Markić D. Wunderlichov sindrom kao prva manifestacija karcinoma bubrega: prikaz slučaja. Medicina Fluminensis [Internet]. 2023 [cited 2024 May 13];59(2):200-203. doi: 10.21860/medflum2023_300580

P. Radoš and D. Markić, "Wunderlichov sindrom kao prva manifestacija karcinoma bubrega: prikaz slučaja", Medicina Fluminensis, vol. 59, no. 2, pp. 200-203, 2023. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:184:209442. [Accessed: 13 May 2024]

Metadata
Title (croatian)Wunderlichov sindrom kao prva manifestacija karcinoma bubrega: prikaz slučaja
Title (english)Wunderlich Syndrome as the First Manifestation of Kidney Cancer: A Case Report
AuthorPaula Radoš
AuthorDean Markić
Author's institutionUniversity of Rijeka
Faculty of Medicine
(Department of Urology)
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Urology
Abstract (croatian)
Cilj: Prikazati bolesnika u kojeg je maligna neoplazma bubrega uzrok Wunderlichovog sindroma i ukazati na važnost prepoznavanja Wunderlichovog sindroma u kliničkoj praksi. Wunderlichov sindrom označava pojavu akutnog, netraumatskog, spontanog krvarenja u supkapsularni ili perirenalni prostor. Prikaz slučaja: Na hitni bolnički prijam primljen je muškarac s bolovima u lijevom dijelu abdomena, praćenih mučninom i vrtoglavicom te jednom tamnijom stolicom. Fizikalnim pregledom nije pronađen nikakav patološki nalaz, ali ultrazvučnim pregledom ustanovljena je veća perirenalna kolekcija. Daljnjom obradom, uključujući i kompjutoriziranu tomografiju, utvrđena je tvorba na gornjem polu lijevoga bubrega, kao i opsežniji perirenalni hematom. Pacijentu je učinjena hitna nefrektomija te evakuacija perirenalnog hematoma. Patohistološki nalaz potvrdio je kako se radi o karcinomu bubrega (svjetlostanični tip) koji je rupturirao. Dvije godine kasnije, pacijent se ponovno javio u hitni bolnički trakt radi teške parapereze. Magnetska rezonancija pokazala je koštane metastaze u području torakalne kralježnice s širenjem u spinalni kanal. Pacijentu je hitno učinjena laminektomija uz redukciju tumora u spinalnom kanalu. Imunohistokemijskim bojenjima dokazano je da se radi o metastazama karcinoma bubrega. Pacijent je upućen na daljnje onkološko liječenje. Zaključak: Wunderlichov sindrom iznimno je rijetka pojava u urološkoj praksi, ali treba biti uključen u diferencijalnu dijagnozu kod pacijenata koji se javljaju s bolovima u lumbalnoj regiji, palpabilnom tvorbom i znakovima šoka. Sindrom je etiološki najčešće vezan uz benigne neoplazme bubrega, ali može biti posljedica malignih novotvorina kao kod našeg bolesnika.
Abstract (english)
Aim: To present a case in which a malignant neoplasm of the kidney is the cause of Wunderlich syndrome and point out the importance of recognizing this syndrome in clinical practice. Case report: A male patient came to the emergency unit with pain in his left hemiabdomen, nausea, dizziness, and a darker stool. Physical examination did not reveal any pathological findings, but ultrasound examination revealed a more abundant perirenal collection. A detailed examination and CT finding revealed a mass on the upper pole of the left kidney as well as a more extensive perirenal hematoma. The urgent nephrectomy was performed and pathohistological findings confirmed that it was renal cell carcinoma (clear cell subtype). Two years later, the patient reappeared in the emergency department of the hospital due to severe paraparesis. After physical examination, the patient was sent for magnetic resonance imaging, which showed secondary pathological remodeling at several levels of the thoracic spine and the spread of the pathological process in the spinal canal. The patient then underwent laminectomy with reduction of the tumor in the spinal canal and the sample was sent for pathohistological analysis. Immunohistochemical staining confirmed renal cell carcinoma metastases. The patient was then sent for further oncological treatment. Conclusion: Wunderlich syndrome has an extremely rare occurrence in urological practice but should be included in the differential diagnosis in patients presenting with lumbar pain, palpable mass and signs of shock. This syndrome is most frequently associated with benign renal neoplasms, but, as in our patient, may be associated with malignant tumors.
Keywords (croatian)
Keywords (english)
Languagecroatian
Languageenglish
Publication typeScientific paper - Case study
Publication statusPublished
Peer reviewPeer review
Publication versionPublished version
Journal titleMedicina Fluminensis
Numberingvol. 59, no. 2, pp. 200-203
p-ISSN1847-6864
e-ISSN1848-820X
DOIhttps://doi.org/10.21860/medflum2023_300580
URN:NBNurn:nbn:hr:184:209442
Publication2023
Document URLhttps://hrcak.srce.hr/300580
Type of resourceText
Access conditionsOpen access
Terms of useLicence Attribution 4.0 International (CC BY 4.0) icon
Created on2023-06-01 10:03:36