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Case Reports
. 2025 Jun 13:2025:9318115.
doi: 10.1155/crpe/9318115. eCollection 2025.

A Benign Renal Tumor With Serious Consequences: A Case Report of Juxtaglomerular Cell Tumor and Chronic Renal Disease in a Teenager

Rachael Courtney  1 , Erin Dahlinghaus  1 , Abiodun Omoloja  1 , Jeffrey T Boyd  2 , Michelle Smith  2 , Laura Biederman  3 , Israel Ndengabaganizi  3 , Daniel Keith Robie  4 , Ahmad Al Dughiem  1
Affiliations
Case Reports

A Benign Renal Tumor With Serious Consequences: A Case Report of Juxtaglomerular Cell Tumor and Chronic Renal Disease in a Teenager

Rachael Courtney et al. Case Rep Pediatr. .

Abstract

Juxtaglomerular cell tumor (JGCT), or reninoma, is a rare benign renal neoplasm. It is characterized by severe hypertension and hypokalemia due to excessive renin produced from the juxtaglomerular apparatus on the afferent arteriole of the glomerulus. Herein, we report a case of JGCT in a 15-year-old female who presented with severe hypertension. She was found to have elevated levels of renin and aldosterone with hypokalemia and she responded to angiotensin-converting enzyme inhibitors (ACEi). Abdominal MRI demonstrated a 4-cm left renal tumor. A radical nephrectomy was performed, and histology showed a well-circumscribed tumor consisting of sheets of polygonal to ovoid cells consistent with a JGCT. After surgery, the renin and aldosterone levels normalized, and blood pressure was controlled with small dose of ACEi medication. Unfortunately, the patient remained in Stage III chronic kidney failure due to the longstanding damage of uncontrolled hypertension prior to the diagnosis. We hereby review the literature and discuss the differential diagnosis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
A mass in the upper pole of the left kidney shown by CT imaging (a). MRI imaging (b) showed a heterogeneous mass within the upper pole of the left kidney measuring 3.8 × 4.1 × 3.6 cm. The lesion demonstrated intermediate to high signal on T2-weighted imaging, intermediate to low signal on T1-weighted imaging, and enhancement similar to the kidney with multiple irregular areas of decreased signal present throughout the lesion. No other focal renal lesions, no hydronephrosis, and no ureteral dilation were noted, and the inferior vena cava was patent.
Figure 2
Figure 2
Gross pathology of the left kidney.
Figure 3
Figure 3
Packed, uniform round-to-polygonal cells.
Figure 4
Figure 4
(a) Hypoperfused glomeruli with periglomeruli fibrosis adjacent to a vessel with intimal fibrosis (PAS 10x). (b) Severe intimal fibrosis in a vessel (PAS 10x). (c) Mildly enlarged glomerulus with arteriole showing concentric remodeling (PAS 20x).
Figure 5
Figure 5
Rhomboid-shaped renin protogranules.
See this image and copyright information in PMC

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