RESUMO
Povidone-iodine sclerosis has been suggested in the literature as a safe and effective treatment for post-renal transplant lymphoceles. No significant complications of this method have been described. We report on a kidney allograft recipient with recurrent lymphoceles treated with povidone-iodine instillations who developed acute renal failure secondary to iodine intoxication. Four days after the beginning of the povidone-iodine irrigations, metabolic acidosis was present, and renal function started to deteriorate. After a few days, despite the suspension of irrigations, the patient developed oliguria, and dialysis was needed. A renal biopsy was performed, and intense acute tubular necrosis was the only relevant finding. The lymphocele was corrected surgically, and the patient eventually recovered. As has been described in other settings, povidone-iodine instillation for the treatment of post-renal transplant lymphoceles may lead to iodine kidney toxicity and acute renal failure.
Assuntos
Injúria Renal Aguda/induzido quimicamente , Transplante de Rim/efeitos adversos , Linfocele/tratamento farmacológico , Linfocele/etiologia , Povidona-Iodo/efeitos adversos , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/tratamento farmacológico , Injúria Renal Aguda/cirurgia , Adulto , Ciclosporina/uso terapêutico , Diagnóstico Diferencial , Drenagem/métodos , Feminino , Humanos , Imunossupressores/uso terapêutico , Linfocele/diagnóstico , Linfocele/cirurgia , Povidona-Iodo/uso terapêutico , Recidiva , Diálise Renal/métodos , Irrigação Terapêutica/efeitos adversos , Irrigação Terapêutica/métodosAssuntos
Transplante de Rim/métodos , Soluções para Preservação de Órgãos/uso terapêutico , Preservação de Órgãos/métodos , Transplante de Pâncreas/métodos , Adulto , Isquemia Fria , Função Retardada do Enxerto/etiologia , Feminino , Rejeição de Enxerto/imunologia , Humanos , Transplante de Rim/efeitos adversos , Transplante de Rim/mortalidade , Masculino , Pessoa de Meia-Idade , Preservação de Órgãos/efeitos adversos , Preservação de Órgãos/mortalidade , Soluções para Preservação de Órgãos/efeitos adversos , Transplante de Pâncreas/efeitos adversos , Transplante de Pâncreas/mortalidade , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
Adenomatoid tumors of adrenal gland are rare, asymptomatic neoplasias, with benign behavior, and usually are diagnosed incidentally. We report a case of a voluminous adenomatoid tumor of left adrenal gland in a 42-year old man who sought evaluation because of renal colic due to left nephrolithiasis. During the investigation, a tumor localized in left adrenal gland was identified by ultrasonography (14.3 x 10.5 x 19.0). The patient underwent adrenalectomy and pyelolithotomy with histopathological and immunohistochemical diagnosis of adenomatoid tumor of adrenal gland, being the largest one described in the literature to the moment. The patient does not present any signs of recurring lesion after a 3-year follow-up.
Assuntos
Tumor Adenomatoide/diagnóstico , Neoplasias das Glândulas Suprarrenais/diagnóstico , Glândulas Suprarrenais/patologia , Tumor Adenomatoide/cirurgia , Neoplasias das Glândulas Suprarrenais/cirurgia , Glândulas Suprarrenais/diagnóstico por imagem , Adrenalectomia , Adulto , Humanos , Masculino , Prognóstico , Resultado do Tratamento , UltrassonografiaRESUMO
Adenomatoid tumors of adrenal gland are rare, asymptomatic neoplasias, with benign behavior, and usually are diagnosed incidentally. We report a case of a voluminous adenomatoid tumor of left adrenal gland in a 42-year old man who sought evaluation because of renal colic due to left nephrolithiasis. During the investigation, a tumor localized in left adrenal gland was identified by ultrasonography (14.3 x 10.5 x 19.0). The patient underwent adrenalectomy and pyelolithotomy with histopathological and immunohistochemical diagnosis of adenomatoid tumor of adrenal gland, being the largest one described in the literature to the moment. The patient does not present any signs of recurring lesion after a 3-year follow-up.