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巨大肾细胞癌患者延迟就诊的结局:一例报告

Outcome of delayed presentation in patients with giant renal cell carcinoma: A case report.

作者信息

Rahmatika Nadya, Wirjopranoto Soetojo, Azmi Yufi Aulia, Putra Antonius Galih Pranesdha, Soetanto Kevin Muliawan

机构信息

Faculty of Medicine, Wijaya Kusuma University, Surabaya, Indonesia.

Department of Urology, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

出版信息

Int J Surg Case Rep. 2024 Dec;125:110541. doi: 10.1016/j.ijscr.2024.110541. Epub 2024 Oct 29.

Abstract

INTRODUCTION AND IMPORTANCE

Renal cell carcinoma (RCC) is a common form of malignancy that causes many deaths worldwide. One of the RCC cases that is challenging and requires proper treatment is a large tumor. This report explores the delayed presentation and treatment of giant RCC.

CASE PRESENTATION

A 53-year-old man came to the referral hospital with a mass in the left pelvis 10 years ago. The patient had been experiencing left flank pain and intermittent hematuria for the past 6 months. Physical examination showed an abdominal mass 20 × 26 cm, cystic consistency, and fixed. A Computed Tomography (CT) scan of the abdomen showed a cystic mass measuring 9.5 × 22.7 × 26.37 cm. The patient underwent a left radical nephrectomy with a chevron incision. The kidney mass was completely removed, and no residual mass or other bleeding was found from the evaluation results. The patient was discharged on the 3rd day after surgery.

CLINICAL DISCUSSION

There was a delay in early detection so the tumor size became large. RCC is considered rare because of its slow growth rate and early detection with imaging techniques. Nephrectomy is the recommended treatment option. All patients should undergo long-term surveillance with routine imaging after nephrectomy to detect recurrent disease early, in this case, the patient is routinely examined every 6 months at follow-up visits.

CONCLUSION

Once a case of giant renal cancer is diagnosed, immediate action must be taken to avoid patient morbidity and mortality.

摘要

引言与重要性

肾细胞癌(RCC)是一种常见的恶性肿瘤形式,在全球范围内导致许多人死亡。具有挑战性且需要恰当治疗的肾细胞癌病例之一是大肿瘤。本报告探讨巨大肾细胞癌的延迟就诊与治疗情况。

病例介绍

一名53岁男性10年前因左盆腔肿物前来转诊医院。患者在过去6个月一直经历左侧腰痛和间歇性血尿。体格检查发现腹部有一个20×26厘米的肿物,质地呈囊性,固定不动。腹部计算机断层扫描(CT)显示一个大小为9.5×22.7×26.37厘米的囊性肿物。患者接受了经人字形切口的左肾根治性切除术。肾脏肿物被完全切除,评估结果显示无残留肿物或其他出血情况。患者术后第3天出院。

临床讨论

早期检测存在延迟,因此肿瘤体积变大。肾细胞癌因其生长速度缓慢且可通过影像学技术早期检测,被认为较为罕见。肾切除术是推荐的治疗选择。所有患者肾切除术后都应通过常规影像学进行长期监测,以便早期发现复发性疾病,在本病例中,患者在随访时每6个月接受一次常规检查。

结论

一旦诊断出巨大肾癌病例,必须立即采取行动以避免患者出现发病和死亡情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aeec/11554637/7ce3686409c4/gr1.jpg

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