Sánchez-López HM, Galeana-Ruiz R, Carvajal-García R, Gutiérrez-Hernández R

Language: Spanish
References: 7
Page: 274-280
PDF size: 481.89 Kb.

ABSTRACT

Urothelial carcinoma of the upper urinary tract (UC-UUT) is rare and represents 5% to 10% of the urothelial carcinomas. Nephroureterectomy with bladder cuff resection continues to be the treatment of choice. However, endoscopic tumor resection, whether by means of ureteroendoscopy (semirigid or flexible) or percutaneous approach, is being carried out more frequently in selected cases.
An 82-year-old woman presented with gross hematuria secondary to an ≈ 2 cm tumor in the urothelium of the upper collecting system of the right kidney and a functionally excluded contralateral kidney. The minimally invasive approach of percutaneous endoscopic bipolar resection was performed. Six months after the resection, the tumor showed radiologic evidence of a lesion that was suggestive of a metachronic tumor in the left excluded kidney. Handassisted laparoscopic nephroureterectomy was carried out and the patient has been disease-free for five years.
Individualized patient treatment is essential in medicine today. The case presented herein illustrates the current tendency to consider nephron-sparing surgery in those patients in whom radical surgery in contraindicated. This type of procedure should be considered in selected patients with normal contralateral kidneys that are candidates for kidney preservation.

REFERENCES

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