[Spontaneous rupture of renal cancer: a case report]

A 53-year-old man presented to our hospital as an emergency admission with sudden right flank pain. No examinations using contrast media could be performed due to allergies. Abdominal plain computed tomography and ultrasonography revealed right peri-renal hematoma, but causes were unknown. Magnetic resonance imaging (MRI) contrasted with gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) revealed right spontaneous rupture of renal cancer and radical nephrectomy was performed. The surgical specimen displayed renal subcapsular hematoma, and histopathology revealed renal clear cell carcinoma, grade 3, INF gamma, pT1a, pV0. The patient was well and without local recurrence or distant metastasis at 14 months postoperatively. Spontaneous rupture of renal cancer is uncommon, and our case is the 68th reported in Japan. MRI is useful for diagnosis and surgical intervention is recommended. Analysis by the Kaplan-Meier method showed good prognosis in spite of spindle cell carcinoma and advanced disease (stage IV).