Hypertension by compression of the renal artery revealing cancer of the ovary

BACKGROUND: The etiologic work-up of hypertension with hyperaldosteronism a nd elevated serum renin includes search for renal artery stenosis. Intrinsi c stenosis is a common finding, but hypertension secondary to extrinsic com pression of the renal artery is exceptional. CASE REPORT: A 48-year-old woman with an uneventful history was hospitalize d for recent onset hypertension. Laboratory tests showed hypokaliemia, and elevated aldosterone and renin. Duplex Doppler exploration of the renal ves sels evidenced extrinsic compression of the left renal artery by a tumoral mass found to be a nodal metastasis at surgery. Pathology reported cancer o f the ovary. Blood pressure, and aldosterone and renin levels returned to n ormal after complete tumor resection. No antihypertensive treatment was req uired. CONCLUSION: This is undoubtedly the first case of metastatic cancer of the ovary revealed by hypertension; it can be added to the list of 49 other pub lished cases of extrinsic compression of the renal artery by various causes leading to hypertension. In most cases, surgical removal of the obstacle o r nephrectomy provided cure of the hypertension.