Hypertension due to a renin-secreting renal tumour

Abstract

Described herein is a young man with severe hypertension who presented with nocturnal enuresis. He was found to have consistently low serum potassium levels associated with a high urinary potassium output. Medical treatment of the hypertension was largely ineffectual. Extensive investigation failed to provide an exact diagnosis preoperatively and two major abdominal explorations were undertaken, together with a subtotal adrenalectomy, before the final discovery of a small intrarenal tumour for which nephrectomy was completed. Following the second operation, blood pressure became normal. A histologic description of the tumour is given which suggests that it was a haemangiopericytoma arising from the juxtaglomerular apparatus. Bioassay of the tumour established beyond doubt that it contained very large quantities of a pressor substance, and that this substance was renin. The methods used to achieve these conclusions are described. In view of the considerable difficulties which arise in making such a diagnosis it is possible that other cases have occurred but have not been recognised; this seems to be the first description of such a tumour which has appeared in the medical literature.