[Asynchronic bilateral renal cell carcinoma: Radical and in situ hypothermia nephron sparing surgeries]
J J Ballesteros Sampol1, A Frances Comalat
1Hospital de la Esperanza, Barcelona, España. jballesteros@imas.imim.es
Objectives:
To present the double action a urologist has to consider in front of a Renal cell carcinoma (RCC); on one hand, when the normality of the contralateral kidney is stated and, on the other hand when, forced by the existence of the tumor in a solitary kidney, it is mandatory to perform a surgical technique to preserve renal function.
Method:
The case of a 43 year-old patient, diabetic who in 1982 underwent left radical nephrectomy for RCC diagnosed during a diagnostic work up for hypertension (HTA). Ten years later an upper pole renal tumor is found in the remaining kidney. Nephron-sparing surgery with in situ hypothermia was performed.
Results:
The patient died 18 years after the first surgery and 8 years after the second. Death was due to diabetic decompensation, haemorrhage from a gastric ulcer and "retroperitoneal mass probably pancreatic" that was not characterized.
Conclusions:
The PSA decline, the histology of the prostate during the adenomectomy and the morphometric changes after surgery and at mid-term, advise a more accurate value of PSA in patients who underwent open sugery, in order to detect a carcinoma in the residual prostate gland.
