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Right renal mass with vena caval thrombus.
D A Goldfarb1, R Lorig, M Zelch
1Department of Urology, Cleveland Clinic Foundation, Ohio.
The Journal of Urology
|March 1, 1990
Summary
Evaluating a nonfunctioning kidney with suspected renal cell carcinoma can be challenging. Urinary cytology is crucial for diagnosis, though management may not change, impacting surgical decisions and adjuvant therapy considerations.
Area of Science:
- Urology
- Oncology
Background:
- Nonfunctioning kidneys present diagnostic challenges, particularly when symptoms suggest renal cell carcinoma.
- Accurate diagnosis is essential for appropriate patient management and treatment planning.
Observation:
- A case involving a nonfunctioning kidney with clinical suspicion of renal cell carcinoma is presented.
- Urinary cytology was not performed on the affected kidney, potentially delaying the definitive diagnosis.
Findings:
- Despite the lack of urinary cytology, the surgical management (ureterectomy) remained unchanged.
- The distal ureter was monitored via ureteral washings and ureteroscopy to avoid further surgery.
- The patient received M-VAC chemotherapy due to the extensive disease and poor prognosis, despite limited data on adjuvant therapy efficacy.
Implications:
- This case highlights the importance of urinary cytology in evaluating nonfunctioning kidneys, especially with suspected malignancy.
- Management strategies for nonfunctioning kidneys with advanced renal cell carcinoma may involve surveillance and adjuvant chemotherapy.
- Further research is needed to establish the role and efficacy of adjuvant therapies in such cases.