López-Verdugo JF, Arrambide-Herrera JG, Aviña-Magaña J, Montelongo-Rodríguez FA

Language: English
References: 10
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ABSTRACT

Description of the clinical case: 61-year-old female who presented to the outpatient clinic, asymptomatic and with an imaging study suggestive of multiple ipsilateral right kidney tumors as well as adrenal incidentaloma. The patient was treated with a laparoscopic partial nephrectomy of both renal tumors and adrenalectomy. Renal cell cancer nuclear grade 2 has been reported in the tumor of the upper pole, angiomyolipoma in the middle region of the kidney and cortical adenoma.
Relevance: Until now, the incidence of synchronous renal tumors at the time of diagnosis is unknown, likewise with new technologies and with greater surgeon’s experience, nephron-preserving surgery has been proposed in multifocal renal tumors for the treatment of this type of tumors.
Clinical implications: There is a controversy and few reports where this type of tumors are treated with nephron-sparing surgery in multifocal tumors. So far in series of clinical cases this technique has been reported as safe and feasible in selected cases.
Conclusions: In expert hands and in particular cases, this technique seems to be a reproducible and safe procedure for the patient, thus ensuring that part of the renal unit is preserved, and good oncological results.

REFERENCES

1. Wells S. Successful Removal of Two Solid Circum Renal Tumours. Br Med J. 1884;1(1216):758– 758. doi: 10.1136/bmj.1.1216.758

2. Campbell S, Uzzo RG, Allaf ME, Bass EB, Cadeddu JA, Chang A, et al. Renal Mass and Localized Renal Cancer: AUA Guideline. J Urol. 2017;198(3):520–9. doi: 10.1016/j. juro.2017.04.100

3. Ljungberg B, Albiges L, Abu-Ghanem Y, Bensalah K, Dabestani S, Fernández-Pello S, et al. European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update. Eur Urol. 2019;75(5):799–810. doi: 10.1016/j. eururo.2019.02.011

4. Winfield HN, Donovan JF, Godet AS, Clayman RV. Laparoscopic Partial Nephrectomy: Initial Case Report for Benign Disease. Journal of Endourology. 1993;7(6):521–6. doi: 10.1089/ end.1993.7.521

5. Ginzburg S, Uzzo RG, Kutikov A. The Role of Minimally Invasive Surgery in Multifocal Renal Cell Carcinoma. Curr Urol Rep. 2012;13(3):202– 10. doi: 10.1007/s11934-012-0251-3

6. No authors listed. NIH state-of-the-science statement on management of the clinically inapparent adrenal mass (‘incidentaloma’). NIH Consens State Sci Statements. 2002;19(2):1–25.

7. Gittens PR, Solish AF, Trabulsi EJ. Surgical management of metastatic disease to the adrenal gland. Semin Oncol. 2008;35(2):172–6. doi: 10.1053/j.seminoncol.2007.12.006

8. Van Poppel H, Da Pozzo L, Albrecht W, Matveev V, Bono A, Borkowski A, et al. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol. 2011;59(4):543–52. doi: 10.1016/j. eururo.2010.12.013

9. Fernández-Pello S, Hora M, Kuusk T, Tahbaz R, Dabestani S, Abu-Ghanem Y, et al. Management of Sporadic Renal Angiomyolipomas: A Systematic Review of Available Evidence to Guide Recommendations from the European Association of Urology Renal Cell Carcinoma Guidelines Panel. Eur Urol Oncol. 2020;3(1):57– 72. doi: 10.1016/j.euo.2019.04.005

10. Kreshover JE, Kavoussi LR, Richstone L. Hilar clamping versus off-clamp laparoscopic partial nephrectomy for T1b tumors. Curr Opin Urol. 2013;23(5):399–402. doi: 10.1097/ MOU.0b013e3283632115