Background: A 51-year-old woman was referred to the Hypertension Clinic of L'Hôtel-Dieu de Québec Hospital, University of Québec Hospital Centre, with hypertension. Her hypertension had been evolving for approximately 30 years and was refractory to maximum doses of four antihypertensive agents. Routine blood testing revealed mild hypokalemia.
Investigations: Physical examination, urine and blood analyses including measurement of renin and aldosterone levels, echocardiography, fundoscopy, abdominal-pelvis CT scan and histopathology studies.
Diagnosis: Juxtaglomerular cell tumor with vascular invasion.
Management: Radical nephrectomy, and follow-up visits to monitor blood pressure and renin levels.