Minimally Invasive Surgery-Based Multidisciplinary Clinical Management of Reninoma: A Single-Center Study

Abstract

Background This article presents our experience in managing a rare kidney tumor – reninoma – by analyzing a relatively large series of cases from a single center. Material/Methods Nine cases of reninoma were reviewed. Clinical manifestations, imaging examinations, laboratory examinations, perioperative data, and pathological findings were summarized. A 58.8-month follow-up was performed to evaluate patient survival and recrudescence. Results The main clinical manifestations were hypertension, hypokalemia, headache, dizziness, nausea, vomiting, palpation, and sweating. Three patients had hypertensive end-organ damage, including brain hemorrhage, gestation termination, and grade III ocular fundus changes. All patients underwent retroperitoneal laparoscopic partial nephrectomy successfully. The mean warm ischemic time was 23.4 min. The median operation time was 95.1 min, with a median estimated blood loss of 60 ml. The median hospital stay was 6 days. No serious intraoperative or postoperative complications occurred. The histology and electron microscopy findings confirmed the diagnosis of reninoma in all cases. After 58.8 months of follow-up, symptoms involving hypertension were relieved in all patients, and no tumor recurrence or metastasis was detected. Conclusions Reninoma may have severe consequences despite being a benign tumor. Retroperitoneal laparoscopic partial nephrectomy is a feasible and effective method for the surgical removal of reninoma. Multidisciplinary cooperation plays an important role in improving the diagnosis and enabling the early surgical treatment of reninoma. Especially in cases of reninoma with moderate and high RENAL scores, an accurate diagnosis of reninoma based on multidisciplinary cooperation facilitates the selection of less invasive surgical approaches.

Accurate lesion localisation facilitates nephron sparing surgery in reninoma patients: case report and discussion

“… 1 Renal vein sampling (RVS) and renal biopsy (RB) are useful diagnostic investigations. 2 Surgical resection is an effective cure for reninoma and accompanying consequences of renin hypersecretion. 2 , 3 Laparoscopic, nephron sparing surgery yields favourable outcomes for these young patients.…”

Pregnancy complicated by juxtaglomerular cell tumor of the kidney: A case report

“…Comparison of renin activity in bilateral renal venous blood by selective or segmental renal venous blood sampling may be helpful in diagnosing JGCT; however, it is not recommended clinically due to its high false-negative rate. Previous studies have shown that the positive rate of this test was about 62.5%; meanwhile, in a study of 14 cases of JGCTs in China, it was only 21.4%[ 14 ]. Our case did not use RAAS inhibitors before the test, and blood test showed hypokalemia, hyperreninemia, and elevated aldosterone; ARR was normal, which was consistent with literature reports.…”

The Role of Real-Time Contrast-Enhanced Ultrasound in Guiding Radiofrequency Ablation of Reninoma: Case Report and Literature Review

“…Surgery procedures, including nephron sparing partial nephrectomy for superficial or small lesions and radical nephrectomy for deep or large lesions, are the mainstream treatment options. The safety and long-term efficacy have been proved with numerous evidences ( 2 , 7 , 8 ). However, when it comes to small nodules with difficulty in intraoperative locating, surgery may lead to prolonged warm ischemic time as well as operation time, and renal dysfunction consequently.…”

“…Treatment modalities include surgery, ablation, and medical therapy. Surgery is the main option, while the effect of medical therapy is very uncertain, and ablation is not widely used but considered a potential alternative ( 2 , 7 , 8 ).…”