Carcinome tubulo-papillaire chez une jeune de 17 ans: à propos d’un cas et revue de la littérature

Tubulopapillary carcinomas account for 10% of renal cell carcinomas. They are more frequent in men than in women (sex ratio:8/1). The average period is the sixth decade. There are two anatomopathological types:the 1 corresponding to a proliferation of basophilic cells and type 2 corresponding to a proliferation of eosinophilic cells. We report the case of a 17-year old female patient with no particular past medical history presenting to the emergency department with pain in the right lumbar fossa and in the right flank associated with hematuria evolving for two days before admission, with loss of body weight and deterioration of the general status. Clinical examination on admission showed poor general condition. The patient was apyretic with blood pressure of 110 mmhg/70mmhg and a heart rate at 110 beats per minute. Abdominal examination based on patient’s inspection showed curvature of the right flank with tenderness, and guarding on palpation. Hemoglobin levels in the blood were 6 g/dl requiring transfusion. Abdominal scan showed voluminous right renal inferior polar tissue formation measuring 10 cm/7.8 cm with peri-renal effusion of 17 mm thickness. Two days after admission patient’s evolution was marked by deglobulisation associated with accentuation of the abdominal pains. The patient underwent hemostatic nephrectomy. Total enlarged right nephrectomy was performed via subcostal incisions. Histological examination revealed type 2 tubulopapillary carcinoma. Chest CT scan did not show secondary tumors.