Wunderlich syndrome as a manifestation in renal cell cancer. Clinical case presentation

Authors

DOI:

https://doi.org/10.48193/eerdd976

Keywords:

Wunderlich syndrome , Kidney cancer, Acute abdominal pain

Abstract

Clinical case description: We present the case of a 41-year-old female patient whose condition began prior to admission with weight loss, accompanied by diaphoresis and nighttime fever. Later, she developed pain in the left renal fossa with a torpid evolution and signs of low output. She was subsequently evaluated for hospital evaluation, where resuscitation maneuvers were initiated and complementary studies were performed. These findings revealed the presence of imaging in the renal unit suggestive of a tumor, as well as a collection in the ipsilateral perinephric space suggestive of a hematoma. A surgical approach was decided upon. The histopathological report revealed clear cell renal cell carcinoma.
Relevance: Although CRC is the second most common cause of WS, it is only observed in 0.3 % to 1.4 % of patients with this condition. However, due to the incidence of CRC, it is the most common malignant neoplasm.

Clinical implications: Mortality associated with Wunderlich syndrome is primarily related to the rapid expansion of the hematoma and the potential for complications such as hypovolemic shock, renal failure, and internal bleeding.
Conclusions: WS represents a urological emergency with a broad etiology that requires a rapid diagnostic approach for timely intervention due to the fatal consequences of delayed treatment.

References

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Parmar K, Thummala Y, Kumar S, Kaundal P, Mandal S. Massive intratumoral bleed in renal cell cancer: an unusual life-threatening event. Annals of the Royal College of Surgeons of England. 2022;104(6): e168–e170. https://doi.org/10.1308/rcsann.2021.0219.

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Published

2026-01-05

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Section

Clinical cases