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NDT Plus Advance Access published online on July 12, 2008
NDT Plus, doi:10.1093/ndtplus/sfn101
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Renal failure and abdominal pain as the presenting symptoms of a rare tumor of the aorta masquerading as a calcified plaque

George Bayliss1, W. Jacobs2 and Mark Williams3

1 Renal Division, Department of Medicine
2 Department of Pathology
3 Renal Division, Joselin Diabetes Center, Beth Israel Deaconess Medical Center, Boston, MA, USA

Correspondence: George Bayliss, Renal Division, Department of Medicine, Beth Israel Deaconess Medical Center, DA 517, 330 Brookline Ave., Boston, MA 02215, USA. Tel: (617) 667-2147; Fax: (617) 667-5276; E-mail: geobayliss{at}gmail.com


  Abstract

Vascular obstructive causes must be considered in chronic renal failure with no obvious cause. We present the case of a 74-year-old woman with smoldering renal failure who undergoes a renal biopsy that did not undercover a cause. As her symptoms persisted and renal function worsened, her nephrologist proposed magnetic resonance angiography with gadolinium and prophylactic initiation of hemodialysis. Imaging uncovered an occlusive aortic mass, which was removed surgically with improvement in renal function. The case discusses the nature of the mass and the need to weigh the risks and benefits of MR imaging with gadolinium and initiation of hemodialysis against the risk of nephrogenic systemic fibrosis.

Key Words: angiosarcoma • coral reef plaque • gadolinium • renal failure

Received for publication May 8, 2008. Accepted for publication June 18, 2008.


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