2014, Número 2
Med Sur 2014; 21 (2)
Bone metastases from renal carcinoma 20 years after diagnosis
Carrillo-Esper R, Peralta-Prado A; Zarate-Vega V, Lavenant-Borja MI
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FRAGMENTO
CLINIC CASEA 83 years old female with familiar history of lung cancer. The patient’s history includes Pott’s disease at 29 years old and systemic arterial hypertension. She underwent right nephrectomy for clear cell carcinoma 20 years ago with oncological follow-up by 13 years without evidence of tumor activity. 30 days before hospital admission she fell and developed severe pain in lower back and right hip for which she received non-steroidal anti-inflammatory, pregabaline and buprenorphine without presenting improvement. She denies fever or weight loss. Physical examination with pallor, tachycardia and pain on right hip movilization, shortening and external rotation of right leg. Laboratories showed hemoglobin 10.2 g/dL, calcium 9.5 mmol/L, corrected calcium 10.5 mmol/L. On plain pelvis radiograph, it was observed right hip pathologic fracture (Figure 1). The magnetic resonance imaging (MRI) showed right hip fracture with significant perilesional edema and tumoral infiltration (Figure 2). The patient underwent bone biopsy of the right hip. The histological diagnosis was bone metastasis of renal clear cell carcinoma (RCCCa) (Figure 3).
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