A case of renal juxtaglomerular cell tumor: Usefulness of segmental sampling to prove autonomic secretion of the tumor

A 27-year-old female patient had been treated for hypertension with convent ional therapy for years, because renal vein renin levels failed to show lat eralization in renal venous samplings and a renal juxtaglomerular cell tumo r (RJGCT) had gone undiagnosed. Abdominal computed tomography revealed a ma ss at the middle of the right kidney. The right renal venogram demonstrated distinct segmental veins from the upper pole and from the middle and lower poles in the right kidney. On segmental renin sampling from each renal vei n, the plasma renin concentration (PRC) of the segmental veins from the mid dle and lower poles was higher than that from other sites. We diagnosed RJG CT of the right kidney and performed right-sided nephrectomy. After the res ection, the PRC rapidly decreased. Immunohistochemical studies using antihu man renin antibodies revealed positive staining of the tumor cells. It is a n important strategy to make a segmental sampling at the site as close as p ossible to the RJGCT.