[Hypertension refractory to therapy]

A 41-year-old musician developed severe refractory hypertension 13 years after radiotherapy of the retroperitoneum because of a teratocarcinoma of the right testis. An angiography revealed severe stenoses of both renal arteries. After percutaneous transluminal angioplasty of both renal arteries, blood pressure valves returned to the normal range. Radiation-induced injury of arteries may provoke premature atherosclerosis, which cannot be differentiated morphologically from common atherosclerosis. Patients who develop severe hypertension some years after radiotherapy of the retroperitoneum should therefore be screened for the presence of renovascular hypertension.