Katsimantas Antonios, Paparidis Spyridon, Bouropoulos Konstantinos, Ferakis Nikolaos
Department of Urology, Korgialenio-Benakio Hellenic Red Cross Hospital, Athanasaki 1, 11526 Athens, Greece.
Case Rep Urol. 2018 Dec 20;2018:4325762. doi: 10.1155/2018/4325762. eCollection 2018.
Sporadic, synchronous, bilateral, or unilateral Renal Cell Carcinomas constitute a rare clinical entity. We report the case of a 68-year-old male patient who presented in our department due to incidentally discovered multiple, bilateral renal tumors. Magnetic Resonance Imaging demonstrated cT1b renal tumors at the lower pole of each kidney and a cT1a renal tumor at the upper pole of the right kidney. The patient underwent transperitoneal, laparoscopic left partial nephrectomy with renal artery occlusion, histology revealed high-grade, pT1b, clear-cell renal cell carcinoma; however we observed decline of patient's estimated glomerular filtration rate postoperatively. Forty days postoperatively, he underwent open partial nephrectomy for the right sided tumors with manual compression of the renal parenchyma and no use of ischemia. Histology revealed high-grade, pT1a, clear-cell renal cell carcinoma at the upper pole of the right kidney and low-grade, pT1b, clear-cell renal cell carcinoma at the lower pole of the right kidney. There was no additional decline in the serum creatinine value postoperatively. The patient avoided permanent or temporary dialysis and 6 months postoperatively he demonstrated no recurrence on imaging and his renal function remained stable.
散发性、同步性、双侧性或单侧性肾细胞癌是一种罕见的临床实体。我们报告一例68岁男性患者，因偶然发现双侧多发肾肿瘤而就诊于我科。磁共振成像显示双侧肾脏下极均为cT1b期肾肿瘤，右侧肾脏上极为cT1a期肾肿瘤。患者接受了经腹腹腔镜下左肾部分切除术并阻断肾动脉，组织学检查显示为高级别、pT1b期透明细胞肾细胞癌；然而，我们观察到患者术后估计肾小球滤过率下降。术后40天，他接受了开放性右肾部分切除术，术中通过手动压迫肾实质，未使用缺血技术。组织学检查显示，右侧肾脏上极为高级别、pT1a期透明细胞肾细胞癌，右侧肾脏下极为低级别、pT1b期透明细胞肾细胞癌。术后血清肌酐值未进一步下降。患者避免了永久性或临时性透析，术后6个月影像学检查未发现复发，肾功能保持稳定。
