D.A. Preciado-Estrella , J. Gómez-Sánchez , J.A. Herrera-Muñoz , V. Cornejo-Dávila , A. Palmeros-Rodríguez , I. Uberetagoyena-Tello de Meneses , L. Trujillo-Ortíz , J. Sedano-Basilio , R. López-Maguey , U. Sánchez-Aquino , G. Viana-Alvarez , G. Veliz-Cabrera , G. Morales-Montor , G. Fernández-Noyola , C. Martínez-Arroyo , M. Cantellano-Orozco , C. Pacheco-Gahbler , S. Parraguirre-Martínez
{"title":"大容量肾肿瘤的处理:关于一个病例","authors":"D.A. Preciado-Estrella , J. Gómez-Sánchez , J.A. Herrera-Muñoz , V. Cornejo-Dávila , A. Palmeros-Rodríguez , I. Uberetagoyena-Tello de Meneses , L. Trujillo-Ortíz , J. Sedano-Basilio , R. López-Maguey , U. Sánchez-Aquino , G. Viana-Alvarez , G. Veliz-Cabrera , G. Morales-Montor , G. Fernández-Noyola , C. Martínez-Arroyo , M. Cantellano-Orozco , C. Pacheco-Gahbler , S. Parraguirre-Martínez","doi":"10.1016/j.uromx.2016.01.006","DOIUrl":null,"url":null,"abstract":"<div><p>The incidence of bulky kidney tumors has decreased thanks to the widespread use of radiographic studies that enable early diagnosis and treatment. However, there are still cases of giant tumors that are true surgical challenges.</p><p>A 47-year-old woman presented with right hemi-abdominal pain 3 years prior, along with increased abdominal circumference, fever, and poor general status. Tomography scan revealed a right kidney tumor (30<!--> <!-->×<!--> <!-->19<!--> <!-->×<!--> <!-->15<!--> <!-->cm) occupying 80% of the abdominal cavity. Radical nephrectomy was performed at the midline with blood loss of 1,800 cc. The patient progressed favorably and was released 48<!--> <!-->h after the procedure. The histopathologic study reported a stage III chromophobe carcinoma (pT3a) that measured 31<!--> <!-->×<!--> <!-->19<!--> <!-->×<!--> <!-->13<!--> <!-->cm and weighed 4,630<!--> <!-->g There was successful oncologic control at 6 months.</p><p>Large-volume kidney tumors are advanced stage lesions associated with poor outcome. Preoperative embolization plays an important role in reducing intraoperative blood loss. If the tumor is considered resectable, the open approach is preferred over the laparoscopic one. Flank approaches (subcostal, supracostal, or transcostal), thoracoabdominal, lumbotomy, or anterior approaches (subcostal, Chevron, midline or paramedian) have been described. The best approach should match the anatomy of the patient and the characteristics of the tumor.</p><p>Bulky renal masses are a surgical challenge. Therapeutic success depends on adequate perioperative evaluation of the patient and the tumor, establishing the ideal approach.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2016.01.006","citationCount":"0","resultStr":"{\"title\":\"Manejo del tumor renal de gran volumen: a propósito de un caso\",\"authors\":\"D.A. Preciado-Estrella , J. Gómez-Sánchez , J.A. Herrera-Muñoz , V. Cornejo-Dávila , A. Palmeros-Rodríguez , I. Uberetagoyena-Tello de Meneses , L. Trujillo-Ortíz , J. Sedano-Basilio , R. López-Maguey , U. Sánchez-Aquino , G. Viana-Alvarez , G. Veliz-Cabrera , G. Morales-Montor , G. Fernández-Noyola , C. Martínez-Arroyo , M. Cantellano-Orozco , C. Pacheco-Gahbler , S. Parraguirre-Martínez\",\"doi\":\"10.1016/j.uromx.2016.01.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>The incidence of bulky kidney tumors has decreased thanks to the widespread use of radiographic studies that enable early diagnosis and treatment. However, there are still cases of giant tumors that are true surgical challenges.</p><p>A 47-year-old woman presented with right hemi-abdominal pain 3 years prior, along with increased abdominal circumference, fever, and poor general status. Tomography scan revealed a right kidney tumor (30<!--> <!-->×<!--> <!-->19<!--> <!-->×<!--> <!-->15<!--> <!-->cm) occupying 80% of the abdominal cavity. Radical nephrectomy was performed at the midline with blood loss of 1,800 cc. The patient progressed favorably and was released 48<!--> <!-->h after the procedure. The histopathologic study reported a stage III chromophobe carcinoma (pT3a) that measured 31<!--> <!-->×<!--> <!-->19<!--> <!-->×<!--> <!-->13<!--> <!-->cm and weighed 4,630<!--> <!-->g There was successful oncologic control at 6 months.</p><p>Large-volume kidney tumors are advanced stage lesions associated with poor outcome. Preoperative embolization plays an important role in reducing intraoperative blood loss. If the tumor is considered resectable, the open approach is preferred over the laparoscopic one. Flank approaches (subcostal, supracostal, or transcostal), thoracoabdominal, lumbotomy, or anterior approaches (subcostal, Chevron, midline or paramedian) have been described. The best approach should match the anatomy of the patient and the characteristics of the tumor.</p><p>Bulky renal masses are a surgical challenge. Therapeutic success depends on adequate perioperative evaluation of the patient and the tumor, establishing the ideal approach.</p></div>\",\"PeriodicalId\":34909,\"journal\":{\"name\":\"Revista mexicana de urologia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.uromx.2016.01.006\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista mexicana de urologia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2007408516000197\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista mexicana de urologia","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2007408516000197","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Manejo del tumor renal de gran volumen: a propósito de un caso
The incidence of bulky kidney tumors has decreased thanks to the widespread use of radiographic studies that enable early diagnosis and treatment. However, there are still cases of giant tumors that are true surgical challenges.
A 47-year-old woman presented with right hemi-abdominal pain 3 years prior, along with increased abdominal circumference, fever, and poor general status. Tomography scan revealed a right kidney tumor (30 × 19 × 15 cm) occupying 80% of the abdominal cavity. Radical nephrectomy was performed at the midline with blood loss of 1,800 cc. The patient progressed favorably and was released 48 h after the procedure. The histopathologic study reported a stage III chromophobe carcinoma (pT3a) that measured 31 × 19 × 13 cm and weighed 4,630 g There was successful oncologic control at 6 months.
Large-volume kidney tumors are advanced stage lesions associated with poor outcome. Preoperative embolization plays an important role in reducing intraoperative blood loss. If the tumor is considered resectable, the open approach is preferred over the laparoscopic one. Flank approaches (subcostal, supracostal, or transcostal), thoracoabdominal, lumbotomy, or anterior approaches (subcostal, Chevron, midline or paramedian) have been described. The best approach should match the anatomy of the patient and the characteristics of the tumor.
Bulky renal masses are a surgical challenge. Therapeutic success depends on adequate perioperative evaluation of the patient and the tumor, establishing the ideal approach.
期刊介绍:
Revista Mexicana de Urología (RMU) [Mexican Journal of Urology] (ISSN: 0185-4542 / ISSN electronic: 2007-4085) is bimonthly publication that disseminates research by academicians and professionals of the international medical community interested in urological subjects, in the format of original articles, clinical cases, review articles brief communications and letters to the editor. Owing to its nature, it is publication with international scope that disseminates contributions in Spanish and English that are rigorously reviewed by peers under the double blind modality. Neither journalistic documents nor those that lack rigorous medical or scientific support are suitable for publication.