Myxoma of the kidney - an unusual benign renal tumor: a case report

Role of N-acetylcysteine in liver injury due to dengue fever

Dengue fever (DF) is a common mosquito-borne viral infection which is endemic in Southeast Asia. Liver involvement may vary from asymptomatic elevation of liver enzymes to fulminant hepatitis. Although the valuable effects of N-acetylcysteine (NAC) in paracetamol toxicity and non-paracetamol liver failure have been extensively studied, its use in DF-associated hepatitis remains unclear. We made a literature search in an online format from libraries such as PubMed, Google Scholar, and EMBASE, and selected 33 articles including original research articles, case reports, and systemic analyses. The majority of the articles reviewed had a positive outcome but treatment strategies involved NAC together with supportive care. Hence, data on sole use of NAC from large randomised control trials remain unclear.

Renal myxoma – a case report of a rare kidney tumor, its differential diagnosis and literature review

Introduction

Myxoma is a rare benign kidney tumor. Only 18 cases have been described in the literature. We report a new case of renal myxoma that arises from the renal parenchyma.

Case presentation

A 56‐year‐old man, medically free, presented complaining of intermittent vague left‐side abdominal pain for 1 year, otherwise no history of gross hematuria or lower urinary tract symptoms. Clinical examination revealed a soft, non‐tender abdomen. All laboratory investigations were within normal. Abdominal and pelvic computed tomography scan with contrast revealed a large mass located in the upper pole of left kidney with the possibility of renal cell carcinoma. A laparoscopic‐assisted left robotic radical nephrectomy was performed. Microscopic examination revealed renal myxoma.

Conclusion

Renal myxoma is a very rare benign kidney tumor with excellent prognosis. Considering its rarity, it is important to recognize this entity to avoid diagnostic errors with other neoplasms with prominent myxoid features.

Report of two primary renal tumors with myxoid features. Differential diagnosis between benign and malignant entities

Renal mesenchymal neoplasms are rare entities which can have a benign or a malignant behavior. Herein we describe two renal mesenchymal tumors with myxoid stroma, investigating the wide spectrum of differential diagnosis. With our first case we considered some benign entities such as myxoma, myxoid leiomyoma, and mixed epithelial and stromal tumor; with our second case we considered some sarcomas with myxoid features such as myxofibrosarcoma, low-grade fibromyxoid sarcoma, dedifferentiated liposarcoma, and myxoid liposarcoma. During the diagnostic process, it is important to integrate histopathological, immunohistochemical, and molecular data in order to avoid misdiagnosis. We concluded our second case report was a myxofibrosarcoma grade 1. To the best of our knowledge, we described the fourth primary renal myxofibrosarcoma reported in literature.

Myxoma of the renal pelvis masquerading pelviureteric stenosis: conservative limited resection with renal preservation: case presentation and literature review

BACKGROUND

Myxoma is a relatively rare mesenchymal tumor seen mainly in the heart and skin. Renal myxomas in particular are exceptionally rare where only 17 cases were previously reported in the English Language literature. Only 2 of the 17 reported cases were located in the renal sinus/pelvis.

CASE PRESENTATION

This is a case of an 18-year-old male patient who complained of right, colicky flank pain associated with abdominal pain and discomfort. Imaging findings revealed right kidney hydronephrosis with a provisional diagnosis of pelviureteric junction (PUJ) stenosis. On computed tomography, there was a very faint thin walled mass abutting the calyces, camouflaged within the dilated renal pelvis. During surgery, a polypoid mass was found at the pelviureteric junction, causing the obstruction. Histological examination showed a hypocellular, paucivascular myxoid neoplasm, with few spindle cells displaying serpentine nuclei and inconspicuous nucleoli. The tumor cells expressed immunoreactivity for vimentin, but not for S100, CD34, actin, or desmin. This will qualify as the third case of renal pelvis myxoma.

CONCLUSION

Myxomas in the renal pelvis/sinus are extremely rare and can present with hydronephrosis and subtle radiological findings mimicking a PUJ stenosis. Being aware of this entity can save the patient unnecessary nephrectomy with possible preservation of the kidney.

Renal myxoma in a pediatric transplant recipient

Renal myxoma is a very rare benign neoplasm seen almost exclusively in adults with only 16 reported cases in the literature. All of these cases have been reported in native kidneys with none being reported in a transplant kidney. We report the case of a renal myxoma in a 17-year-old boy's transplant kidney that was found as an incidental mass on ultrasonography and further evaluated with CT and PET scans. PET findings of a renal myxoma are reported here for the first time, and imaging findings from previous cases are briefly reviewed. This case report highlights the fact that adult-predominant tumors and pathology should always be a consideration in pediatric patients who receive organ transplants from adult donors.