Acute gouty arthritis following percutaneous cryoablation of renal cell carcinoma

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Abstract

We report a case of acute gouty monoarthritis of the left ankle in a 58-year-old female with chronic renal insufficiency after cryoablation of a 3.8 cm left renal cell carcinoma. The patient's symptoms resolved after intravenous Solumedrol and did not recur at her 1-month follow-up visit. To the best of our knowledge, this is the first reported case of acute gouty monoarthritis after cryoablation of a renal cell carcinoma lesion in a patient with underlying chronic renal insufficiency. Clinicians should be vigilant of the potential for this complication in at-risk patient populations.

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Most cited references 19

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The epidemiology of renal cell carcinoma.

Börje Ljungberg, Steven Campbell, Han Choi … (2011)

Kidney cancer is among the 10 most frequently occurring cancers in Western communities. Globally, about 270 000 cases of kidney cancer are diagnosed yearly and 116 000 people die from the disease. Approximately 90% of all kidney cancers are renal cell carcinomas (RCC). The causes of RCC are not completely known. We have reviewed known aetiologic factors. The data provided in the current review are based on a thorough review of available original and review articles on RCC epidemiology with a systemic literature search using Medline. Smoking, overweight and obesity, and germline mutations in specific genes are established risk factors for RCC. Hypertension and advanced kidney disease, which makes dialysis necessary, also increase RCC risk. Specific dietary habits and occupational exposure to specific carcinogens are suspected risk factors, but results in the literature are inconclusive. Alcohol consumption seems to have a protective effect for reasons yet unknown. Hardly any information is available for some factors that may have a high a priori role in the causation of RCC, such as salt consumption. Large collaborative studies with uniform data collection seem to be necessary to elucidate a complete list of established risk factors of RCC. This is necessary to make successful prevention possible for a disease that is diagnosed frequently in a stage where curative treatment is not possible anymore. Copyright © 2011. Published by Elsevier B.V.

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EAU guidelines on renal cell carcinoma: the 2010 update.

Börje Ljungberg, Nigel Cowan, Damian C Hanbury … (2010)

The European Association of Urology Guideline Group for renal cell carcinoma (RCC) has prepared these guidelines to help clinicians assess the current evidence-based management of RCC and to incorporate the present recommendations into daily clinical practice. The recommendations provided in the current updated guidelines are based on a thorough review of available RCC guidelines and review articles combined with a systematic literature search using Medline and the Cochrane Central Register of Controlled Trials. A number of recent prospective randomised studies concerning RCC are now available with a high level of evidence, whereas earlier publications were based on retrospective analyses, including some larger multicentre validation studies, meta-analyses, and well-designed controlled studies. These guidelines contain information for the treatment of an individual patient according to a current standardised general approach. Updated recommendations concerning diagnosis, treatment, and follow-up can improve the clinical handling of patients with RCC. (c) 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.

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Pathophysiology, clinical consequences, and treatment of tumor lysis syndrome.

J Hix, Sebastian Schreiber, Lisa B. Davidson … (2004)

Tumor lysis syndrome is an oncologic emergency that is characterized by severe electrolyte abnormalities and, frequently, by acute renal failure. The syndrome typically occurs in patients with lymphoproliferative malignancies, most often after initiation of treatment. The pathophysiology involves massive tumor cell lysis resulting in the release of large amounts of potassium, phosphate, and uric acid. Deposition of uric acid and calcium phosphate crystals in the renal tubules may lead to acute renal failure, which is often exacerbated by concomitant intravascular volume depletion. The kidney normally excretes these products, and consequently preexisting renal failure exacerbates the metabolic derangements of tumor lysis syndrome. Standard treatment aims to clear high plasma levels of potassium, uric acid, and phosphorus; correct acidosis; and prevent acute renal failure by way of aggressive intravenous hydration; lowering serum potassium levels; use of allopurinol; urinary alkalinization; or renal replacement therapy (if necessary). Allopurinol is the standard of care for treating hyperuricemia of malignancy, but is associated with drawbacks. Recombinant urate oxidase (rasburicase), which recently became available in the United States, provides a safe and effective alternative to allopurinol for lowering uric acid levels and preventing uric acid nephropathy.

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Author and article information

Contributors

Ahmed-Zayn Mohamed

Journal

Journal ID (nlm-ta): Radiol Case Rep

Journal ID (iso-abbrev): Radiol Case Rep

Title: Radiology Case Reports

Publisher: Elsevier

ISSN (Electronic): 1930-0433

Publication date PMC-release: 26 September 2019

Publication date Collection: November 2019

Publication date (Electronic): 26 September 2019

Volume: 14

Issue: 11

Pages: 1432-1437

Affiliations

[a ]University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL 33612, USA

[b ]Tampa General Hospital, University of South Florida, Morsani College of Medicine, Tampa, FL 33606, USA

Author notes

[* ]Corresponding author. Ahmohamed@ 123456health.usf.edu

Article

Publisher ID: S1930-0433(19)30288-2

DOI: 10.1016/j.radcr.2019.09.003

PMC ID: 6823770

SO-VID: 0e3b7a4b-13ff-48ff-9454-fd2598132411

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

History

Date received : 5 August 2019

Date revision received : 2 September 2019

Date accepted : 2 September 2019

Acute gouty arthritis following percutaneous cryoablation of renal cell carcinoma

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Abstract

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Gamma Delta T cells

Most cited references 19

The epidemiology of renal cell carcinoma.

EAU guidelines on renal cell carcinoma: the 2010 update.

Pathophysiology, clinical consequences, and treatment of tumor lysis syndrome.

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