[In situ tumor excision of a renal neoplasm]

The present work reviews the conservative surgical options to treat renal tumor formation in patients who still have both kidneys, and tries to clarify the diagnostic aspects, indications and therapeutical alternatives. The controversial items are analyzed versus treatments advocating a radical surgical approach, establishing a parallelism with current trends of surgical non-intervention in renal traumatism of moderate to severe condition (grade II). A case is presented where these two pathological circumstances are concurrent: Renal traumatism with complete parenchymatous rexhis and contralateral solid renal mass, both treated conservatively. Pre-surgical diagnosis was left renal traumatism grade II and righ renal neoformation and was based in findings with CAT and arteriographia. Histology of the piece from tumorectomy was renal angiomyolipoma. After a post-surgical evolution of twelve months, therapeutical results were assessed as excellent, with no evidence of either immediate not late complications. Considering data recently communicated by most authors, the concept of simple tumorectomy or renal tumoral enucleation is suggested as valid. However, arguments both clinical and surgical, in order to confirm its indication, require very rigorous criteria and a careful selection of patients.