Renal cell carcinoma in the elderly: Is partial nephrectomy the right surgical option?

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. e15040-e15040
Author(s):  
M. H. Hayn ◽  
N. J. Hellenthal ◽  
W. Underwood ◽  
H. L. Kim ◽  
T. Schwaab
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Renal Cell ◽  
The Elderly ◽  
The Right ◽  
Surgical Option

scholarly journals Laparoscopic partial nephrectomy for renal cell carcinoma in a horseshoe kidney

2014 ◽  
Vol 8 (11-12) ◽  
pp. 918 ◽  
Author(s):  
Tarik Benidir ◽  
Tiago Jacometo Coelho de Castilho ◽  
Guilherme Rodrigo Lobo Cherubini ◽  
Murilo De Almeida Luz
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Renal Cell ◽  
Laparoscopic Approach ◽  
Horseshoe Kidney ◽  
Renal Calculi ◽  
Clinical Situation ◽  
Laparoscopic Partial Nephrectomy ◽  
The Right

Horseshoe kidney has an incidence rate ranging from 1 in 400 to 1 in 1000, with a 2:1 ratio in men. It also has a predilection for chromosomal aneuploidies. From a pathophysiology standpoint, this anomaly occurs during the second to sixth week of gestation when the inferior portion of the metanephric blastema fuses to form an isthmus, commonly in the lower renal pole (90%). As a result of this fusion, the kidney may not bypass the inferior mesenteric artery and is impeded in its ascent. With an aberrant anatomical orientation and location, complications arise including hydronephrosis, renal calculi and a twofold risk of Wilms tumour. Despite these findings, the association of renal cell carcinoma (RCC) within a horseshoe kidney is extremely rare and fewer than 200 cases have been described. Therapeutically speaking, partial nephrectomies are the gold standard of treatment for renal tumours smaller than 4 cm in diameter, with a growing indication to accomplish this procedure by laparoscopic or robotic means. We report a case of an asymptomatic 58-year-old male with an incidental computed tomography scan finding of a 4-cm solid mass in the right moiety of a horseshoe kidney. He was treated by laparoscopic partial nephrectomy. There have only been 2 other reported cases to our knowledge on a laparoscopic partial nephrectomy in a horseshoe kidney for RCC. We believe that, in experienced hands, the laparoscopic approach may be used successfully for this clinical situation.

scholarly journals Renal cell carcinoma of horseshoe kidney

2020 ◽  
pp. 72-72
Author(s):  
Milomir Tufegdzic ◽  
Vladimir Vasic ◽  
Jovan Hadzi-Djokic
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Renal Cell ◽  
Horseshoe Kidney ◽  
Ct Urography ◽  
Lower Pole ◽  
Macroscopic Hematuria ◽  
Patient Reported ◽  
The Right

Introduction. Horseshoe kidney is the most common developmental disorder of the urinary system, which involves an anomaly of kidney fusion, and occurs in 3% of the population. Kidneys are most often connected at the lower poles by fibrous or parenchymal isthmus. Renal cell carcinoma (RCC) is the most common tumor of the horseshoe kidney. Treatment involves surgical treatment that includes heminephrectomy or partial nephrectomy with different approaches. We report a case of RCC of a horseshoe kidney, located on lower pole and isthmus. Case outline. A sixty-eight-year-old patient reported to the urologist due to intermittent painless macroscopic hematuria. CT urography revealed the presence of a tumor on the right kidney measuring 85 ? 90 ? 60 mm, with radiological characteristics of RCC, which covered the entire lower pole of the kidney towards the isthmus. Angiography finding indicated thickened isthmus with pronounced malformation of vascular structures. The right heminephrectomy was performed with resection of the isthmus from 15 mm to healthy tissue. The isthmus was sutured in two layers with a catgut suture. Subsequently, hilar, paracaval, and interaorthocaval lymphadenectomy were performed. The pathohistological finding indicated a tumor of renal cell origin while the resection line was free of tumor tissue, as were the lymph nodes Conclusion. RCC is the most common neoplasm of the horseshoe kidney. Treatment is surgical and involves open or laparoscopic heminephrectomy or partial nephrectomy with a transperitoneal or extraperitoneal approach.

45: Enucleation of Renal Cell Carcinoma with Ablation of Tumor Base: Is Cancer Control Comparable to Partial Nephrectomy?

2006 ◽  
Vol 175 (4S) ◽  
pp. 16-16
Author(s):  
Alexander Kutikov ◽  
Lindsay K. Fossett ◽  
Thomas J. Guzzo ◽  
Alan J. Wein ◽  
Keith N. Vanarsdalen ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Renal Cell ◽  
Cancer Control

Clinical characteristics and treatments of hereditary leiomyomatosis renal cell carcinoma: two case reports and literature review

2020 ◽  
Author(s):  
Dalin Feng ◽  
Mingshuai Wang ◽  
Xiaodong Zhang ◽  
Jianwen Wang
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Female Patient ◽  
Male Patient ◽  
Renal Cell ◽  
Clinical Characteristics ◽  
Genetic Test ◽  
Enhanced Ct ◽  
The Right ◽  
Hereditary Leiomyomatosis

Abstract Background The objective of this study is to discuss clinical characteristics and treatments of hereditary leiomyomatosis renal cell carcinoma on the basis of 2 cases and to review recent literature, in order to present medical advances. Methods A 29-year old male patient came to our hospital because of a huge tumour on the right kidney. Enhanced CT showed that the tumour was about 15.5*10.5 cm, and was considered to be malignant. Another case was a 38-year old female patient. She complained was found to have a right kidney tumour in a routine physical examination. Enhanced CT showed an early-stage tumour of about 4.3*3.7 cm on the lower pole of the right kidney. The male patient underwent open radical nephrectomy and the female patient underwent laparoscopic radical nephrectomy and extensive retroperitoneal lymph node dissection. The two patients underwent genetic testing and were diagnosed as having hereditary leiomyomatosis with renal cell carcinoma. Results The postoperative pathology in both patients revealed type 2 papillary renal cell carcinoma but with different prognosis. The male patient suffered multiple metastasis 10 months post-operation. The metastatic tumour of the abdominal wall was resected to confirm recurrence and hereditary leiomyomatosis renal cell carcinoma was diagnosed by the genetic test. While the female patient had a specific family history and uterine leiomyomas, the genetic test helped us to identify hereditary leiomyomatosis renal cell carcinoma pre-operation. Because of the early diagnosis and timely treatment, the female patient was considered to have a good prognosis. Conclusion Hereditary leiomyomatosis renal cell carcinoma is a rare hereditary disease resulting from FH gene mutation. There are currently no effective treatments.Our cases demonstrate that hereditary leiomyomatosis renal cell carcinoma is a very aggressive disease. Early screening and surveillance are recommended for patients with a family history or who are at risk of hereditary leiomyomatosis renal cell carcinoma. Surgical and palliative therapy still play an important role in clinical treatment.

scholarly journals Metastatic renal cell carcinoma extending to the left atrium through the inferior pulmonary vein

2021 ◽  
Author(s):  
Alan G Dawson ◽  
Cathy J Richards ◽  
Leonidas Hadjinikolaou ◽  
Apostolos Nakas
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Left Atrium ◽  
Pulmonary Vein ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Pulmonary Veins ◽  
Lower Lobe ◽  
Inferior Pulmonary Vein ◽  
The Right

Abstract Metastatic renal cell carcinoma with involvement through the pulmonary veins to the left atrium is very rare. We report the case of a 70-year-old male with metastatic renal cell carcinoma to the right lower lobe of the lung abutting the inferior pulmonary vein with extension to the left atrium without pre-operative evidence. Surgical resection was achieved through a posterolateral thoracotomy. Lung masses that abut the pulmonary veins should prompt further investigation with a pre-operative transoesophageal echocardiogram to minimize unexpected intraoperative findings.

scholarly journals Detection of a peritumoral pseudocapsule in patients with renal cell carcinoma undergoing robot-assisted partial nephrectomy using enhanced MDCT

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Makoto Toguchi ◽  
Toshio Takagi ◽  
Yuko Ogawa ◽  
Satoru Morita ◽  
Kazuhiko Yoshida ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Renal Cell ◽  
Clear Cell ◽  
Robot Assisted ◽  
High Attenuation ◽  
Papillary Rcc ◽  
Clear Cell Rcc

AbstractTo investigate the detection of peritumoral pseudocapsule (PC) using multi-detector row computed tomography (MDCT) for tumors resected by robot-assisted laparoscopic partial nephrectomy (RAPN) for T1 renal cell carcinoma (RCC). Study participants included 206 patients with clinical T1 RCC who underwent RAPN between October 2017 and February 2018. Two radiologists who were blinded to the pathological findings evaluated the computed tomography (CT) images. Radiological diagnosis of a PC was defined by a combination of observations, including a low-attenuation rim between the tumor and renal cortex in the cortico-medullary phase and a high-attenuation rim at the edge of the tumor in the nephrogenic or excretory phase. A PC was detected on CT in 156/206 tumors (76%) and identified by pathology in 182/206 (88%) tumors including 153/166 (92%) clear cell RCC, 13/14 (93%) papillary RCC, and 7/16 (44%) chromophobe RCC. In the whole cohort, CT findings showed a sensitivity of 81.3% (148/182), specificity of 66.7% (16/24), and positive predictive value of 94.9% (148/156). When the data were stratified according to pathological subtypes, MDCT was observed to have a sensitivity of 86.9% (133/153) and specificity of 61.5% (8/13) in clear cell RCC, sensitivity of 38.5% (5/13) and specificity of 100% (1/1) in papillary RCC, and sensitivity of 44.4% (4/7) and specificity of 66.7% (6/9) in chromophobe RCC. A low or high-attenuation rim around the tumor in the cortico-medullary or nephrographic-to-excretory phase indicates a PC of RCC, though the accuracy is not satisfactory even with 64- or 320-detector MDCT.

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