A patient with a floating kidney and nephrotic syndrome
Clinical Nephrology. 2012 Dec 4. [Epub ahead of print] [Link]
Choi M, Schneider W, Elitok S, Luft FC, Kettritz R.
Asymptomatic retroperitoneal fluid is rarely detected. We encountered a young man with known nephrotic syndrome who presented with left-sided abdominal pain. He had very little peripheral edema, but a massive fluid collection around a “floating” left kidney, as determined by three different imaging studies. Large amounts of fluid and a cyst surrounding the kidney were removed laparascopically and malignancy was excluded. The patient had a rare benign cystic mesothelioma together with focal-segmental glomerulosclerosis. Both diseases do not seem to be causally related. Complete surgical resection of the mesothelioma is the definitive treatment. If resection is incomplete, recurrence is frequent. Indeed, when our patient returned some years later for an elective hernia repair, the fluid collection had recurred.
December 10, 2012
- (A-simp-toh-matic) not having any symptoms of a disease. Many cancers can develop and grow without producing symptoms, especially in the early stages. Screening tests such as mammograms help to find these early cancers, when the chances for cure are usually highest. (See also screening.)
- (be-nine) not cancer; not malignant.
- (sist) a fluid-filled mass that is usually benign. The fluid can be removed for analysis.
- (eh-deem-uh) build-up of fluid in the tissues, causing swelling. Edema of the arm can occur after radical mastectomy, axillary dissection of lymph nodes, or radiation therapy.
- any method used to produce a picture of internal body structures. Some imaging methods used to detect cancer are x-rays (including mammograms and CT scans), magnetic resonance imaging (MRI), scintigraphy, and ultrasound.
- a tumor derived from mesothelial tissue, such as the peritoneum (lining the abdomen) or pleura (lining the lungs). More on mesothelioma.
- cancer that has come back after treatment. Local recurrence is when the cancer comes back at the same place as the original cancer. Regional recurrence is when the cancer appears in the lymph nodes near the first site. Distant recurrence is when it appears in organs or tissues (such as the lungs, liver, bone marrow, or brain) farther from the original site than the regional lymph nodes. Metastasis means that the disease has recurred at a distant site.
- surgery to remove part or all of an organ or other structure.