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Persistent retroperitoneal haematoma from undiagnosed renal cell carcinoma in a young trauma patient
  1. Mitchell Egerton Barns1,
  2. Bryce Stewart1,
  3. Janez Cernelc2 and
  4. Yuigi Yuminaga1
  1. 1Department of Urology, Royal Perth Hospital, Perth, Western Australia, Australia
  2. 2Anatomical Pathology, Royal Perth Hospital, Perth, Western Australia, Australia
  1. Correspondence to Dr Mitchell Egerton Barns; mitch{at}barnscorp.com

Abstract

A man in his 20s presents to the emergency department after a water skiing accident and was diagnosed with a grade 3 left renal laceration. He subsequently required cystoscopic insertion of a ureteric stent after failing a trial of conservative management. Over the next 9 months, he re-presented to the hospital twice with increasing flank pain and fevers. Subsequent imaging demonstrated interval progression of the retroperitoneal haematoma with a suspicious calcified lower pole lesion which was biopsied subsequently and revealed malignant tissue. External compression of the kidney by this large haematoma was also thought to be contributing to a state of Page kidney. The patient underwent definitive management with an open left-sided radical nephrectomy which confirmed type 2 papillary renal cell carcinoma. The patient is now normotensive and back to his baseline function. He will undergo surveillance CT imaging and be referred to familial genetic services.

  • Urological surgery
  • Renal medicine
  • Surgery
  • Cancer intervention

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Footnotes

  • Contributors MEB: primary author of manuscript. BS: assistant author of manuscript, including editing and referencing. YY: consultant for the case and general supervision of report. JC: anatomical pathologist who reported the case and provided images.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.