ABSTRACT
A 10-year-old girl, with an intermittent fever for 15 days, visited our emergency department. Initial work-up revealed no signs of infection and no palpable abdominal mass. KUB showed only displaced bowel gas. Abdominal ultrasound was performed which disclosed a huge mass at the lower pole of the right kidney. Abdominal computed tomography (CT) confirmed a huge, heterogeneous mass arising from the right kidney and without involvement of regional lymph nodes and inferior vena cava. Radical nephrectomy was performed and Stage 2 renal cell carcinoma (RCC) was confirmed. Fever subsided spontaneously after operation. No local recurrence or distant metastasis was detected in the following 3 years. Thus, occult malignant neoplasm as infrequent as RCC should be in the list of differential diagnoses of fever of unknown origin (FUO). An abdominal ultrasound is a useful screening tool for early diagnosis of RCC.
Subject(s)
Carcinoma, Renal Cell/complications , Fever of Unknown Origin/etiology , Kidney Neoplasms/complications , Carcinoma, Renal Cell/diagnosis , Carcinoma, Renal Cell/pathology , Child , Female , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/pathologyABSTRACT
A 7-year-old Chinese boy with steroid-resistant nephrotic syndrome developed thalamic stroke secondary to straight sinus thrombosis. He was hospitalized due to status epilepticus and coma. The child recovered after treatment by low-molecular-weight heparin (LMWH) and warfarin. This case highlights the importance of magnetic resonance imaging with venography in the early diagnosis of cerebral sinus thrombosis (CST) in nephrotic children and the effectiveness of anticoagulation therapy in improving the neurological outcome.
