Abstract Ref Number = APCP1080
ACUTE KIDNEY INJURY IN A 16 YEARS OLD BOY WITH MALIGNANT TERATOMA
Tommy Sulaiman,Syafruddin Haris
Syiah Kuala University
Background : Acute kidney injury (AKI) is a clinical syndrome in which a sudden deterioration in renal function results in the inability of the kidneys to maintain fluid and electrolyte homeostasis. Teratomas are germ cell tumors commonly composed of multiple cell types derived from one or more of the 3 germ layers “ectoderm, mesoderm, and endoderm”. Teratomas may be asymptomatic and found incidentally or can show compressive symptoms.
Case Presentation Summary : A sixteen years old boy with body weight 46 kg, came to Zainoel Abidin hospital with complaints of a lump at the stomach, vomiting, lower extremity edema, and oliguria. Physical examination: palpable solid mass at the abdominal region, flat surface, immobile and no tenderness. Laboratory findings: Hb: 10,3 g/dL, Ht: 29%, Wbc: 8.500/mm3, Platelet: 305.000/mm3, Sodium: 132 mmol/L, Potasium: 4,4 mmol/L, Chloride: 101 mmol/L, ureum serum: 295 mg/dL, creatinine serum: 21,66 mg/dL and GFR: 4,84 ml/min/1,73m2. Urologic ultrasound: Bilateral Hydronephrosis. Computed tomography of the abdomen: Intraabdominal giant solid tumor with intrahepatal metastases. Biopsy: Malignant teratoma. The patient was treated regularly by hemodialysis 3 times a week, underwent nephrostomy to evacuate accumulated urine and chemotherapy as palliative therapy to treat the malignant teratoma.
Learning Points/Discussion : In this case, the etiology of acute kidney injury is enlarged mass of malignant teratoma that pressed the ureter. Hemodialysis is done to maintain the renal function, Nephrostomy to evacuate accumulated urine, and chemotherapy to treat the underlying disease. This case has poor prognostic because the renal function has been disrupted, the tumor is malignant and has already metastated.
Keywords: Acute kidney injury Teratoma Renal function