Bilateral Renal Tumour: A case report
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https://doi.org/10.54212/27068048.v9i2.2Keywords:
Bilateral Renal Tumour, VHL, Nephron-sparing surgery (Partial nephrectomy)Abstract
Objective: Report a case of bilateral renal tumors <10 cm, limited to renal units without data of metastasis, reviewing the history and medical-surgical approach. Clinical Case Presentation: A 41-year-old male patient, without present comorbidities, with a history of surgery for a brain tumor in the posterior fossa in 2019. He presented with predominantly right lumbar pain, no masses were palpated on physical examination. UroTC shows the presence of bilateral renal tumors, a right mass of 47 x 60 x 46 mm, a left mass of 51 x 68 x 59 mm, with enhancement to the contrast medium. A bilateral polar nephrectomy was performed, with a histopathological result of bilateral clear cell renal cell carcinoma. Discussion: The approach to bilateral renal tumors is complex, when the imaging characteristics suggest a high degree of malignancy, an approach to tumor resection should be performed in its modalities Radical nephrectomy (NR) or partial nephrectomy (PN). Evidence it is weak in terms of the adequate approach when the masses are bilateral, because only limited case reviews are available in the world literature. The risk in the surgical procedure is high due to the complications that can occur with a high presentation of bleeding that cannot be controlled. In general, PN is considered only in tumors> 4cm that are limited to the renal unit in special conditions such as single-kidney patients, bilateral renal tumors, or CKD in advanced stages.1 Conclusion: Nephron-sparing surgery is a useful resource with good surgical results in patients with special conditions, despite finding unfavorable histopathological findings with margins taken, the evidence indicates that the risk of metastasis or decrease in clear cell carcinoma is not increased. only 16% of the cases with positive surgical margins have local recurrence of the tumor.2,3
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B. Ljungberg (Chair), L. Albiges, J. Bedke, A. Bex (Vice- Chair) et al. EAU Guidelines. Renal Cell Carcinoma. Presented at the EUA Annual Congress Milan 2021. ISBN 978-94-92671-13-4.
Tellini, R., et al. Positive Surgical Margins Predict Progression-free Survival After Nephron-sparing Surgery for Renal Cell Carcinoma: Results from a Single Center Cohort of 459 Cases with a Minimum Follow-up of 5 Years. Clin Genitourin Cancer, 2019. 17:e26. https://pubmed.ncbi.nlm.nih.gov/30266249 https://doi.org/10.1016/j.clgc.2018.08.004 DOI: https://doi.org/10.1016/j.clgc.2018.08.004
Sundaram, V., et al. Positive margin during partial nephrectomy: does cancer remain in the renal remnant? Urology, 2011. 77: 1400. https://pubmed.ncbi.nlm.nih.gov/21411126 https://doi.org/10.1016/j.urology.2010.12.016 DOI: https://doi.org/10.1016/j.urology.2010.12.016
Moch, H., et al. The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours. Eur Urol, 2016. 70: 93. https://pubmed.ncbi.nlm.nih.gov/26935559 https://doi.org/10.1016/j.eururo.2016.02.029 DOI: https://doi.org/10.1016/j.eururo.2016.02.029
C. Martínez Rodríguez, G. Tardáguila de la Fuente, A.M. Villanueva Campos, Manejo actual de las masas renales pequeñas, Radiología, Volume 62, Issue 3, 2020, Pages 167-179, ISSN 0033-8338, https://doi.org/10.1016/j.rx.2019.11.004 DOI: https://doi.org/10.1016/j.rx.2019.11.004
A. Vilaseca, M. Musquera, D.P. Nguyen, et al. Evolución de la técnica quirúrgica en el manejo de la masa renal. Actas Urol Esp. 2016;40(3):148---154. https://doi.org/10.1016/j.acuro.2015.08.009 DOI: https://doi.org/10.1016/j.acuro.2015.08.009
Sacco, E., et al. Paraneoplastic syndromes in patients with urological malignancies. Urol Int, 2009. https://doi.org/10.1159/000224860 DOI: https://doi.org/10.1159/000224860
Hemal AK, Kumar A, Kumar R, Wadhwa P, Seth A, Gupta NP. Laparoscopic versus open radical nephrectomy for large renal tumors: a long-term prospective comparison. J Urol. 2007 Mar;177(3):862-6. PMID: 17296361. https://doi.org/10.1016/j.juro.2006.10.053 DOI: https://doi.org/10.1016/j.juro.2006.10.053
I. SALINAS VERT. Von Hippel-Lindau's disease, Rev., Endocrinología y Nutrición, Elsevier, España 1999
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