Graham-Boyle-Troxell Syndrome

At a glance

A very rare medical condition characterized by cystic nonmalignant hamartomas affecting both the lungs and kidneys.

Synonym

Cystic Hamartoma of Lung and Kidney.

Incidence and genetic inheritance

Three cases have been reported worldwide. Inheritance unknown.

Clinical aspects

Clinical features involve the lungs (hamartomatous pulmonary cysts, lung fibrosis respiratory distress, chronic inflammatory lung disease) and the genitourinary system (bilateral multilocular cysts of the kidney, abdominal masses, renovascular hypertension, cellular mesoblastic nephroma, and possible markedly hyperplastic renomegaly with medullary dysplasia).

Anesthetic considerations

No literature available. Evaluate renal function (clinical, ultrasound, laboratory) and adapt intraoperative fluid regimen and drug choice (avoid nephrotoxic drugs and prefer those with nonrenal elimination). Evaluate respiratory function (clinical, chest radiographs, CT, pulmonary function tests, arterial blood gas analysis). Postoperative ventilatory support might be necessary. Perioperative chest physiotherapy can be useful. Avoid excessive airway pressures that could lead to cystic rupture of pulmonary malformations. Intraoperative invasive blood pressure monitoring may be justified.

References