Juxtaglomerular cell tumor in a young male presenting with new onset congestive heart failure

Abstract

Renin secreting juxtaglomerular cell tumors are extremely rare benign tumors of the kidney. In this case, we highlight the atypical presentation of a young male patient presenting with vague complaints of worsening dyspnea, shortness of breath and anxiety. Initial workup of troponinemia and elevated BNP was initially most suggestive of a major cardiac event. An ejection fraction of 20% confirmed that this patient presented with heart failure. However, only further workup with imaging and renin and aldosterone labs revealed a functional renal mass as the cause. Timely intervention was pursued and pathology of the tumor was consistent with a juxtaglomerular cell tumor.

Keywords: Hypertension; Juxtaglomerular cell tumor; Renal mass; Urologic oncology.

Fig. 1

T1 MR image with arrow demonstrating a left lower pole mass with nodular component concerning for malignancy.

Fig. 2

Tumor cells demonstrating high mitotic activity with abundant eosinophilic cytoplasm and rounded nuclei with frequent intranuclear inclusions.

Fig. 3

Tumor cells staining positive for Vimentin.