Andrade Mariana A, Caires Filipa, Duarte Carla C, Santana Catarina, Saldanha Cristina
Caniço Health Center, Hospital Dr. Nélio Mendonça, Serviço de Saúde da Região Autónoma da Madeira (SESARAM), Funchal, PRT.
Machico Health Center, Hospital Dr. Nélio Mendonça, Serviço de Saúde da Região Autónoma da Madeira (SESARAM), Funchal, PRT.
Cureus. 2025 Mar 30;17(3):e81469. doi: 10.7759/cureus.81469. eCollection 2025 Mar.
Renal cell carcinoma (RCC) is responsible for most cases of primary kidney neoplasms, many of which are asymptomatic until an advanced stage. According to the World Organization of Family Doctors (WONCA), in primary health care, family doctors (FD) hold a privileged position in the early diagnosis of the disease's natural history. This case presents a 61-year-old man who sought consultation with his FD for swelling in the right frontal region with a two-week history. He denied trauma or accompanying symptoms. Clinically, he presented with a right frontal swelling, 3 cm in diameter, tender to palpation, and without inflammatory signs. Given these findings, the FD requested an ultrasound of the soft tissues and later a contrast-enhanced cranial-encephalic computed tomography (CT) scan, which showed the presence of a solid nodule located in the right frontal region, centered on the bone calotte and highly vascularized, with the most likely diagnostic hypothesis being a tumor lesion, primary versus secondary. Subsequently, the patient underwent a contrast-enhanced chest-abdomen-pelvis CT, which revealed the presence of a neoplasm in the right kidney, consistent with RCC. This clinical case report aims to highlight the crucial role of the FD in detecting pathologies such as RCC, which can present in an undifferentiated manner at an early stage of its natural history, in addition to the management of preventive care and follow-up of individualized comorbidities.
肾细胞癌（RCC）是原发性肾脏肿瘤的主要病因，其中许多在晚期之前没有症状。根据世界家庭医生组织（WONCA）的说法，在初级卫生保健中，家庭医生（FD）在该疾病自然史的早期诊断中具有特殊地位。本病例介绍了一名61岁男性，他因右额部肿胀两周而向其家庭医生咨询。他否认有外伤或伴随症状。临床上，他表现为右额部肿胀，直径3厘米，触诊时有压痛，无炎症体征。鉴于这些发现，家庭医生要求对软组织进行超声检查，随后进行增强型颅脑计算机断层扫描（CT），结果显示右额部有一个实性结节，以颅骨为中心，血管丰富，最可能的诊断假设是肿瘤病变，原发性与继发性。随后，患者接受了增强型胸部-腹部-骨盆CT检查，结果显示右肾有一个肿瘤，符合肾细胞癌。本临床病例报告旨在强调家庭医生在检测肾细胞癌等疾病方面的关键作用，这些疾病在其自然史的早期可能以未分化的方式出现，此外还包括预防性护理的管理和个体化合并症的随访。
