Wunderlich syndrome pada penderita clear cell renal cell carcinoma

Abstract

Wunderlich's syndromes is a collection of symptoms consisting of pain, palpable mass in the flank region, hematuria associated with spontaneous renal bleeding. Renal cell carcinoma (RCC) is defined as a group of malignancies originating from the epithelium of the renal tubules. Reportedly a man, aged 47 years, with complaints of pain in the waist and upper left abdomen, accompanied by reddish urine since 3 days before being admitted to the hospital, but also experienced one month ago. On physical examination, there was a solid mass in the abdomen accompanied by tenderness. Ultrasound examination of the upper-lower abdomen showed a solid lobulated mass of impression originating from the left kidney. MSCT examination found a mass of the left kidney measuring about 11.2 cm x 16.7 cm x 20.2 cm which caused enhancement of the left renal artery. The patient then underwent a radical nephrectomy, found a left kidney tumor measuring 20 cm which was attached to the diaphragm. The result of the PA histo examination, obtained tumor cells with an increased N / C ratio, polygonal to round oval shape, moderate pleimorphic core, hyperchromatic, prominent core children, wide clear vacuole cytoplasm and partly eosinophilic with the impression of Clear Cell Renal Cell Carcinoma Grade. III. Patient diagnosed as CCRCC with wunderlich syndrome manifestation. .Further management was planned for systemic chemotherapy or radiation treatment, but the patient refused. The patient was discharged on the 20th day of treatment in good condition.