RENIN-SECRETING TUMORS - DIAGNOSIS, CONSERVATIVE SURGICAL APPROACH AND LONG-TERM RESULTS

During the last 15 years 8 patients were diagnosed with renin secretin g juxtaglomerular cell tumors among 30,000 hypertensive patients. Clin ical characteristics included severe hypertension poorly medically con trolled in young patients (mean age 22.3 years) and severe hypokalemia (mean 2.83 mmol./l.). Secondary hyperaldosteronism was present in all cases with a constant elevation of renin activity. Renal vein samplin g was only positive in 64% of cases. Selective renal arteriography dem onstrated an avascular area in 43% of the patients. Computerized tomog raphy showed the tumor in all cases. Mean tumor size was 24 mm. (range 10 to 50). Conservative surgery was feasible in all patients. Periope rative ultrasonography was used for 3 intraparenchymal tumors. Hyperte nsion and hypokalemia resolved within 1 week after surgery. At a mean followup of 98 months (range 24 to 204) no tumor recurrence was docume nted.