Carcinoma de células renales papilar avanzado, nefrectomía radical y trombectomía de vena cava inferior

Introduction

Papillary renal cell carcinoma is the second most frequent type of kidney cancer, representing 13 to 15% of lesions. Its greatest incidence is between the third and eighth decades of life and there is a 2 to 1 predominance in males. There are 2 morphologic types of papillary renal cell carcinoma and type 2 has the worse prognosis. Presentation is sporadic and unilateral in the majority of cases.

Clinical case

A 42-year-old man had no history of chronic degenerative disease and was a chronic smoker. He presented with gross hematuria of 20-day progression and severe anemia associated with general malaise. An abdominal computed axial tomography scan showed a 10 × 12 cm heterogeneous mass at the interpolar and lower pole region of the right kidney, retroperitoneal adenopathies, and a subdiaphragmatic vena cava thrombus. Right radical nephrectomy and thrombectomy of the inferior vena cava were performed. The histopathology study reported type 2 papillary renal cell carcinoma extending into the perirenal fat and adrenal gland and an inferior vena caval tumor thrombus.

Conclusions

Even though our patient had a poor short-term survival prognosis given the advanced clinical stage of his disease, palliative surgical management was indicated due to the persistent hematuria resulting in anemia.