A tumoral mass (local recurrence of renal cell carcinoma) causing massive intraabdominal bleeding after blunt abdominal trauma

Int J Surg Case Rep. 2016;20:57-9. doi: 10.1016/j.ijscr.2016.01.001. Epub 2016 Jan 16.

Abstract

Background: Solid organ injury after abdominal trauma is a common condition, however, injury of the local recurrent tumoral masses following abdominal trauma is rare. The injuries and bleeding in recurrent tumors tend to be highly serious since they are more fragile. The bleedings caused by renal cell carcinomas and by the traumatic laceration of their recurrence commonly occur in the retroperitoneum. In this report, we present a 55-year-old female patient who underwent emergency surgery due to intraabdominal bleeding and bleeding was from the recurrence of a renal cell carcinomas.

Presentation of case: The 55-year-old female patient was admitted to the emergency service with intraabdominal bleeding. Physical examination revealed tenderness in the right lower quadrant, particularly in the traumatic area. Ultrasonography and computed tomography revealed diffuse intraabdominal fluid and a ruptured bleeding mass was excised. Pathological analysis indicated that the mass was isolated local recurrence of renal cell carcinoma.

Discussion: Solid organ injury caused by blunt abdominal trauma may be accompanied by tumoral laceration; however, minor bleeding may occur in cases with blunt trauma, coexistence of blunt abdominal trauma with local recurrence and massive bleeding is extremely rare. Control of bleeding is more challenging in tumoral tissues compared to normal tissues. The bleeding intraabdominal area rather than the retroperitoneal area, and this condition was attributed to the peritoneal tear caused by the trauma.

Conclusion: Local recurrent tumoral masses may be the source of the intraabdominal massive bleeding after blunt trauma.

Keywords: Blunt abdominal trauma; Local recurrence; Renal cell carcinoma.