Giant renal calculus in a solitary functioning kidney

Area of Science:

• Nephrology
• Urology
• Surgical Case Reports

Background:

• Giant renal calculi are rare, posing significant clinical challenges.
• Solitary functioning kidneys necessitate meticulous surgical approaches to preserve renal function.
• This report details a unique case of extreme nephrolithiasis in a compromised renal system.

Observation:

• A 47-year-old male presented with lumbar pain, an abdominal mass, and hematuria.
• Physical examination revealed a large, palpable abdominal mass.
• Imaging studies confirmed a giant renal calculus (230 x 140 mm, 1,350 g) in the right kidney, with an atrophic, nonfunctioning left kidney.

Findings:

• The patient had a solitary functioning right kidney containing a massive calcium phosphate renal calculus.
• Nephrolithotomy was successfully performed to remove the stone.
• This represents the largest and heaviest renal calculus reported in a solitary functioning kidney.

Implications:

• Highlights the extreme end of renal calculus presentation.
• Demonstrates the feasibility of surgical intervention (nephrolithotomy) for massive stones in solitary kidneys.
• Emphasizes the importance of comprehensive diagnostic imaging in evaluating complex renal masses.