PAGE Phenomenon in a Crossed Fused Renal Ectopia: A Rare Phenomenon in a Rare Anomaly
- Genetic Diseases: Cystic - Genetic Analysis and Extrarenal Manifestations
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Genetic Diseases of the Kidneys
- 1201 Genetic Diseases of the Kidneys: Cystic
- Heis, Farah, Monmouth Medical Center, Long Branch, New Jersey, United States
- Ravilla, Jayasree, Monmouth Medical Center, Long Branch, New Jersey, United States
- Heis, Mohamed, Yarmouk University, Irbid, Jordan
PAGE phenomenon is rare. It occurs due to an external compression of the renal parenchyma, usually by subcapsular hematoma. Crossed fused renal ectopia (CFRE) is another rare finding. We present an unusual case of a young female with CFRE complicated by PAGE kideny due to pheochromocytoma.
A 28 yo F with CFRE presented with Rt flank pain for 3 days. Pain was severe, radiating to the back, associated with nausea. She denied vomiting and headache. In the ED, she was found to have hypertensive urgency, BP 202/117, HR 103 bpm. PE was significant for RLQ tenderness with no rebound or rigidity. Blood work showed Hgb of 11.3 g/dL. CMP, including BUN and Cr were wnl. US of the abdomen showed diffuse echogenic appearance of the Rt kidney with scattered cysts. CT Urogram showed large Rt retroperitoneal and subcapsular hematoma and a heterogenous right suprarenal mass. She was admitted to the ICU and was treated with Nicardipine drip. Urine catecholamines were significantly elevated. Patient was stabilized and was transferred to urologic oncology surgeon for intervention.
PAGE kidney is rare and is commonly traumatic or iatrogenic. However, it can be caused by an adrenal mass. It carries high morbidity especially in patients with solitary kidney and CFRE. Urgent intervention is warranted to salvage the kidney.
CT Abdomen showing CFRE
CT Abdomen showing Rt adrenal mass with active bleeding.