Renin-producing serous cystoadenocarcinoma of the ovary: a case report

Background: Only a few renin-producing ovarian tumors have been reported, and most such ovarian tumors have been sex cord/stromal tumors. Renin-producing ovarian epithelial tumors are quite rare.

Case: A 46-year-old woman presented with hypertension and hypokalemia. Examinations of the patient revealed elevated plasma renin activity, hyperaldosteronism and a pelvic mass. Subsequently, a right ovarian tumor mass was resected. Microscopic observation of the tumor revealed a well-differentiated serous cystadenocarcinoma. Immediately after surgery, blood pressure, serum potassium, plasma renin activity and plasma aldosterone levels returned to normal ranges. RT-PCR analysis and immunohistochemical staining of this tumor indicated that it was producing renin.

Conclusion: This is the first report of a renin-producing ovarian serous cystadenocarcinoma.

Renin-producing ovarian tumor; Hyperreninism

[1] Chirgwin J. M., Przybyla A. E., MacDonald R. J., Rutter W. J.: "Isolation of biologically active ribonucleic acid from sources enriched in ribonuclease". Biochemistry, 1979, 18 (24), 5294.

[2] Imai T., Miyazaki H., Hirose S., Hori H., Hayashi T., Kageyama R. et al.: "Cloning and sequence analysis of cDNA for human renin precursor". Proc. Natl. Acad. Sci. USA., 1983, 80 (24), 7405.

[3] Kanda R., Orikasa S., Sakai K., Ota S., Kimura N.: "The distnbution of renin containing cells in scarred kidneys". J. Ural., 1996, 156 (4), 1450.

[4] Nagahama M., Nakayama K., Murakami K.: "Sequence reqmrements for prohormone processing in mouse pituitary AtT-20 cells Analysis using prorenins as model substrates". Eur. J. Biochem., 1991, 197 (/), 135.

[5] Robertson P. W., Klidjian A., Harding L. K., Walters G., Lee M R., Robb-Smith A.H.: "Hypertension due to a renin-secreting renal tumour". Am. J. Med., 1967, 43 (6), 963.

[6] Camilleri J. P., Hinglais N., Bruneval P., Bariety J., Tricottet Y., Rouchon M. et al.: "Renin storage and cell differentiation in juxtaglomerular cell tumors: an immunohistochemical and ultrastructural study of three cases". Hum. Pathol., 1984, 15 (11), 1069.

[7] Squires J. P., Ulbright T. M., DeSchryver-Kecskemeti K., Engleman W.: "Juxtaglomerular cell tumor of the kidney". Cancer, 1984, 53 (3), 516.

[8] Hollifield J. W., Page D. L., Smith C., Michelakis A. M., Staab E., Rhamy R.: "Ren in-secreting clear cell carcinoma of the kidney" Arch. Intern. Med., 1975, 135 (6), 859.

[9] Lebel M., Talbot J., Grose J., Morin J.: "Adenocarcinoma of the kidney and hypertension: report of 2 cases with special emphasis on renin". J. Ural., 1977, 118 (6), 923.

[10] Tomita T., Poisner A., Inagami T.: "lmmunohistochemical locahzation of renin in renal tumors". Am. J. Pathol., 1987, 126 (1), 73.

[11] Ganguly A., Gribble J., Tune B., Kempson R. L., Luetscher J. A: "Renin-secreting Wilms'tumor with severe hypertension. Report of a case and brief review of renin-secreting tumors". Ann. Intern. Med., 1973, 79 (6), 835.

[12] Bauer J. H., Durham J., Miles J., Hakami N., Groshong T.: "Congenital mesoblastic nephroma presenting with primary reninism" J. Pediatr., 1979, 95 (2), 268.

[13] Genest J., Rojo-Ortega J. M., Kuchel 0., Boucher R., Nowaczynski W., Lefebvre R. et al.: "Malignant hypertension with hypokalemia in a patient with renin-producing pulmonary carcinoma" Trans. Assoc. Am. Physicians., 1975, 88, 192.

[14] Hauger-Klevene J. H.: "High plasma renin activity in an oat cell carcinoma: a renin-secreting carcinoma'1". Cancer, 1970, 26 (5), 1112

[15] Ruddy M. C., Atlas S. A., Salerno F. G.: "Hypertension associated with a renin-secreting adenocarcinoma of the pancreas". N. Engl. J. Med., 1982, 307 (16), 993.

[16] Cox J. N., Paunier L., Vallotton M. B., Humbert J. R., Rohner A.: "Epithelial liver hamartoma, systemic arterial hypertension and renin hypersecretion". Virchows. Arch. A. Pathol. Anal. Histol., 1975, 366 (/), 15.

[17] Yokoyama H., Yamane Y., Takahara J., Yoshinouchi T., Ofuji T.: "A case of ectopic renin-secreting orbital hemangiopericytoma associated with juvenile hypertension and hypokalemia". Acta Med. Okayama., 1979, 33 (4), 315.

[18] Aurell M., Rudin A., Tisell L. E., Kindblom L. G., Sandberg G.: "Captopril effect on hypertension in patient with renin-producing tumour". Lancet, 1979, 2 (8134), 149.

[19] Corvo! P:." Tumor-dependent hypertension". Hypertension, 1984, 6 (4), 593.

[20] Korzcts A., Nouriel H., Steiner Z., Griffel B.. Kraus L., Freund U, et al.: "Resistant hypertension associated with a renin-producing ovarian Sertoli cell tumor". Am. J. Clin. Pathol.. 1986, 85 (2), 242.

[21] Tetu B., Lebel M., Camilleri J. P.: "Renin-producing ovarian tumor. A case report with immunohistochemical and electronmicroscopic study''. Am. J. Surg. Pathol.. 1988, 12 (8), 634.

[22] Anderson P. W., Macaulay L., Do Y. S., Sherrod A., D'Ahlaing G., Koss M. et al.: "Extrarenal renin-secreting tumors: insights into hyperteusion and ovarian renin production". Medicine, 1989, 68(5), 257.

[23] Fox R., Eckford S., Hirschowitz L., Browning J., Lindop G.: "Refractory gestational hypertension due to a renin-secreting ovarian fibrothecoma associated with Gorlin's syndrome". B1: J. Obstet. Gynaecol, 1994, 101 (11), 1015.

[24] Atlas S. A., Hesson T. E., Sealey J. E., Dharmgrongartama B., Laragh J. H., Ruddy M. C. et al.: "Characterization of inactive renin ("prorenin") from renin-secreting tumors of nonrenal origin Similarity to inactive renin from kidney and normal plasma". J Clin. Invest.. 1984, 73 (2), 437.

[25] De Nuccio I., Salvati G., Genovesi G., Paolini P., Marcellini L, Schiavello V et al.: "Physiopathology of the renin-angiotensin system in the ovary". Minerva. Endacrinal., 1999, 24 (2), 77.