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Papers of the Week

2022 Sep 15

BMJ Case Rep



Persistent retroperitoneal haematoma from undiagnosed renal cell carcinoma in a young trauma patient.


Barns M E, Stewart B, Cernelc J, Yuminaga Y
BMJ Case Rep. 2022 Sep 15; 15(9).
PMID: 36109097.


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.