6 research outputs found
Surgical treatment of renal cell carcinoma recurrence at the renal fossa following radical nephrectomy
Surgical treatment of renal cell carcinoma recurrence at the renal fossa following radical nephrectomy
CONTEXT: Isolated renal cell carcinoma recurrence at the renal fossa is a rare event. This condition occurs in 1 to 2% of radical nephrectomy cases. It is usually seen in postoperative follow-up imaging examinations such as abdominal computed tomography or abdominal ultrasound. There is controversy among urologists and oncologists regarding the best way to treat this rare situation, because of the few cases in the literature. CASE REPORT: We report on a case of isolated recurrence at the renal fossa due to renal cell carcinoma (RCC), four and a half years after radical nephrectomy, without evidence of metastases in other organs. The diagnosis was made from abdominal tomography performed during outpatient follow-up, in which a retroperitoneal mass was observed in the renal fossa. Excision was carried out by means of a subcostal transversal incision, without complications. One and a half years after the procedure, there was evidence of metastasis in the left lung and, six months later, another recurrence at the ninth anterior right rib, while the patient remained asymptomatic. Aggressive surgical treatment is a good method for controlling this rare situation of single retroperitoneal RCC recurrence. Abdominal tomography must continue to be performed over long periods of follow-up, to monitor for RCC following radical nephrectomy, in order to diagnose any late retroperitoneal recurrences. These must be treated as single RCC metastases
Surgical treatment of renal cell carcinoma recurrence at the renal fossa following radical nephrectomy
CONTEXTO: A recorrência local única do carcinoma renal de células claras em seu leito renal após nefrectomia radical é um evento raro. Estima-se que essa situação ocorra em 0,8% a 3,6% do total de procedimentos. Comumente, seu diagnóstico é realizado através de tomografia computadorizada de abdômen ou ultra-som renal usados no acompanhamento desses pacientes. É polêmico qual o melhor tratamento dessa rara condição entre urologistas e oncologistas devido aos poucos relatos em literatura. RELATO DE CASO: Relatamos um caso de recidiva neoplásica única no leito renal após quatro anos e meio da nefrectomia radical por adenocarcinoma de células claras, sem evidência de metástases a distância em outros órgãos. O diagnóstico foi realizado por meio de tomografia abdominal em acompanhamento ambulatorial, observando-se massa retroperitoneal em topografia renal. A massa foi retirada por meio de uma incisão subcostal ampliada, em cirurgia sem intercorrências. O paciente evoluiu bem no pós-operatório. Após um ano e meio do procedimento, foi evidenciada uma metástase no pulmão esquerdo, e seis meses após, outra recorrência metastática na nona costela anterior à direita, mesmo com paciente totalmente assintomático. O tratamento cirúrgico agressivo em recorrência local única é um bom método para controlar essa rara doença. Tomografia computadorizada de abdômen deve ser feita em acompanhamento de carcinoma renal por longos perÃodos após a nefrectomia radical para o diagnóstico de recorrências tardias e o tratamento deve ser feito como o de uma metástase recorrente única.CONTEXT: Isolated renal cell carcinoma recurrence at the renal fossa is a rare event. This condition occurs in 1 to 2% of radical nephrectomy cases. It is usually seen in postoperative follow-up imaging examinations such as abdominal computed tomography or abdominal ultrasound. There is controversy among urologists and oncologists regarding the best way to treat this rare situation, because of the few cases in the literature. CASE REPORT: We report on a case of isolated recurrence at the renal fossa due to renal cell carcinoma (RCC), four and a half years after radical nephrectomy, without evidence of metastases in other organs. The diagnosis was made from abdominal tomography performed during outpatient follow-up, in which a retroperitoneal mass was observed in the renal fossa. Excision was carried out by means of a subcostal transversal incision, without complications. One and a half years after the procedure, there was evidence of metastasis in the left lung and, six months later, another recurrence at the ninth anterior right rib, while the patient remained asymptomatic. Aggressive surgical treatment is a good method for controlling this rare situation of single retroperitoneal RCC recurrence. Abdominal tomography must continue to be performed over long periods of follow-up, to monitor for RCC following radical nephrectomy, in order to diagnose any late retroperitoneal recurrences. These must be treated as single RCC metastases
Tratamento cirúrgico na recidiva retroperitoneal tardia por carcinoma renal de células claras após nefrectomia radical
Late renal cell carcinoma recurrence in the renal fossa is a rare event. This condition occurs in 1 to 2% of radical nephrectomies. We reported a late recurrence at the renal fossa about four and half years after radical nephrectomy due to a renal cell carcinoma (RCC) without metastasis elsewhere. Diagnosis in an outpatient follow-up was made during an abdominal computed tomography and we observed a retroperitoneal mass in the renal fossa. The excision at the recurrence area was made through a subcostal transversal incision without any difficulty. After 6 months from this second procedure, there was no evidence of recurrence. The surgical aggressive treatment for late retroperitoneal RCC recurrence is a good method in this rare situation. Abdominal computed tomography must be done during long periods of follow-up for patients with radical nephrectomy for RCC to search for late retroperitoneal recurrences
Tratamento cirúrgico na recidiva retroperitoneal tardia por carcinoma renal de células claras após nefrectomia radical
Late renal cell carcinoma recurrence in the renal fossa is a rare event. This condition occurs in 1 to 2% of radical nephrectomies. We reported a late recurrence at the renal fossa about four and half years after radical nephrectomy due to a renal cell carcinoma (RCC) without metastasis elsewhere. Diagnosis in an outpatient follow-up was made during an abdominal computed tomography and we observed a retroperitoneal mass in the renal fossa. The excision at the recurrence area was made through a subcostal transversal incision without any difficulty. After 6 months from this second procedure, there was no evidence of recurrence. The surgical aggressive treatment for late retroperitoneal RCC recurrence is a good method in this rare situation. Abdominal computed tomography must be done during long periods of follow-up for patients with radical nephrectomy for RCC to search for late retroperitoneal recurrences