[Two stage nephron sparing operation for synchronous bilateral renal cell carcinoma: a case report]

We present a case of synchronous bilateral renal cell carcinoma successfully treated with preservation of renal function. A 68-year-old man was admitted with complaints of gross hematuria and left back pain in February 1994. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a round mass 5 cm in diameter in the middle posterior portion of the right kidney and another one 7 cm in diameter in the upper pole of the left kidney. At first the right renal mass was enucleated in situ with a temporary vascular occlusion under surface cooling. Left radical nephrectomy was followed after confirmation of functional recovery of the right kidney on the 20th postoperative day of the first operation. Histopathological examination of the surgical specimens revealed that both masses were renal cell carcinoma, alveolar type, clear cell subtype. The pathological stage of the right and left renal cell cancer was pT2 and pT3a, respectively. The patient retained good renal function, with a serum creatinine concentration of 1.2 mg/dl and has been free of disease for nine months after the second operation.