ISSN 2326-7283
African Journal of Internal Medicine ISSN: 2326-7283 Vol. 2 (5), pp. 037-041, July, 2013. © International Scholars Journals
Case Report
Successful right nephrectomy and left tumourectomy for sporadic bilateral synchronous renal cell carcinoma
A Murinello1, P Guedes1, AM Figueiredo1, P Gomes1, LA Monteiro2, HS Damásio1, NC Ribeiro3, L Mota4, A Carvalho5, C Teiga3, M Albergaria3, A Serrano1
1Internal Medicine 1 Department, Hospital de Curry Cabral – Rua da Beneficência 8, 1069-166 Lisbon, Portugal.
2 Urology Department, Hospital de Curry Cabral – Rua da Beneficência 8, 1069-166 Lisbon, Portugal.
3 Radiology Department, Hospital de Curry Cabral – Rua da Beneficência 8, 1069-166 Lisbon, Portugal.
4 Intensive Care Unit, Hospital de Curry Cabral – Rua da Beneficência 8, 1069-166 Lisbon, Portugal.
5Pathology Department, Hospital de Curry Cabral – Rua da Beneficência 8, 1069-166 Lisbon, Portugal.
Corresponding author. E-mail: [email protected], [email protected], [email protected].
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Accepted 2 May, 2013
Abstract
Renal cell carcinoma (RCC) is by far the most frequent type of kidney cancer, but synchronous bilateral neoplasms are rare, even more so in sporadic forms of RCC. An increasing amount of tumours are being found spuriously while small and before causing any symptoms, thus allowing less invasive surgery with potentially brighter outcomes. We report a 49-year-old Caucasian male who presented to the Emergency Department with a seven-day course of productive cough, worsening dyspnoea, and anorexia. He had no history of fever or any pain, and showed no abdominal or urinary complaints whatsoever. His physical exam was irrelevant apart from an enlarged liver, and kidney function tests were normal. Workup eventually revealed synchronous bilateral clear cell RCC and the patient underwent a successful total right nephrectomy with left tumourectomy. Two years on, he remains asymptomatic and with normal renal function. This case shows the seldom seen coexistence of sporadic RCC in both kidneys. We stress the fact that the patients frequently don’t show any urinary symptoms, which can delay the correct diagnosis and hinder treatment. Tumours found on an early stage can be dealt with using less drastic measures that spare nephrons and elude, or at least postpone, definitive haemodialysis.
Key words: kidney cancer, sporadic bilateral synchronous renal cell carcinoma, clear cell renal cell carcinoma, guided percutaneous diagnostic kidney biopsy, nephron-sparing surgery.