A case of retroperitoneal mature B-cell lymphoma with acute renal failure at first visit

Abstract

An 11-year-old girl developed intermittent numbness and pain in the soles of both feet. After a month, she experienced numbness in both arms and diarrhea. Abdominal computed tomography (CT) revealed extensive tumors in the retroperitoneal cavity and obstructed ureters. Because of elevated levels of serum potassium (8.8 mEq/L) and creatinine (16.8 mg/dL), we performed hemodialysis on admission and bilateral ureteral stenting the next day for acute renal failure. CT/MRI demonstrated tumor invasion into the spinal canal from L4 to S1. We diagnosed the patient as having mature B cell lymphoma on the basis of retroperitoneal biopsy findings. Treatment in accordance with the guidelines of JPLSG B-NHL-14 was commenced, and a week later, the patient’s neurological symptoms disappeared. After nine months, the patient was in complete remission. Her serum creatinine level became normal. Previous reports showed that most patients with pediatric malignant lymphoma/leukemia of the retroperitoneum or kidney with acute renal failure recovered their renal function and had a favorable prognosis after appropriate treatment in the acute phase. These suggest that it is important to perform prompt initial treatments.