Renal tumor and trauma: a pitfall for conversative management

Renal tumor and trauma: a pitfall for conversative management

Autor Abib, Simone de Campos Vieira Autor UNIFESP Google Scholar
Leite, Mila Torii Corrêa Autor UNIFESP Google Scholar
Ribeiro, Rodrigo Chaves Autor UNIFESP Google Scholar
Fachin, Camila Girardi Autor UNIFESP Google Scholar
Demuner, Maris Salete Autor UNIFESP Google Scholar
Cypriano, Monica Autor UNIFESP Google Scholar
Schettini, Sérgio Tomaz Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo PURPOSE: Conservative management has been largely used for renal trauma. Although this approach is safe and highly recommended, it can hide a pre-existing unknown condition, such as tumors or urinary malformations. A high index of suspicion is needed for early recognition of these conditions. We present four cases treated at the Pediatric Oncology Institute - Federal University of São Paulo, which have been initially treated conservatively for renal trauma. MATERIALS AND METHODS: We reviewed all 218 renal cases of renal tumors treated at our institution in a 22-year period, searching for associated trauma events. RESULTS: Four cases of renal tumors were initially treated conservatively for blunt renal trauma of low energy mechanism. Patients' ages ranged from 7 to 12 years old. Two patients had no previous symptoms, one patient had hematuria and another had an abdominal mass. Computerized Axial Tomography (CT) of the abdomen revealed disparate magnitude of the renal bleeding to the low energy mechanism of trauma. All patients underwent surgical treatment. Kidney specimens showed Wilms tumor in three cases and renal carcinoma in one. CONCLUSIONS: The association between renal tumors and trauma should be suspected when renal trauma hemorrhage on abdominal CT scan does not match the low energy mechanism of blunt abdominal trauma. The key for a successful diagnosis of renal tumor or congenital malformations is the high index of suspicion for these conditions.
Palavra-chave injuries
kidney
neoplasms
treatment outcome
diagnosis
Idioma Inglês
Data de publicação 2011-08-01
Publicado em International braz j urol. Sociedade Brasileira de Urologia, v. 37, n. 4, p. 514-518, 2011.
ISSN 1677-5538 (Sherpa/Romeo, fator de impacto)
Publicador Sociedade Brasileira de Urologia
Extensão 514-518
Fonte http://dx.doi.org/10.1590/S1677-55382011000400011
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000300365100012
SciELO S1677-55382011000400011 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/6534

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