Diagnostic and therapeutic considerations in bilateral renal carcinoma. Report of a case and review of the literature

• Published in: Archivos españoles de urología Vol. 44; no. 6; p. 683
• Main Authors: Martínez Bengoechea, J J, Liédana Torres, J M, Gil Sanz, M J, Urruchi Fernández, P, Rioja Sanz, L A
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-07-1991
• Subjects: Adenocarcinoma - diagnosis; Adenocarcinoma - epidemiology; Adenocarcinoma - surgery; Biopsy, Needle; Diagnostic Imaging; Humans; Incidence; Kidney Neoplasms - diagnosis; Kidney Neoplasms - epidemiology; Kidney Neoplasms - surgery; Male; Middle Aged; Neoplasms, Multiple Primary - diagnosis; Neoplasms, Multiple Primary - epidemiology; Neoplasms, Multiple Primary - surgery; Nephrectomy
• ISSN: 0004-0614

Conservative surgery is considered to be the treatment of choice in patients with bilateral renal tumors or tumor in the solitary kidney owing to the need to preserve renal function. A case of a 63-year-old patient with bilateral renal carcinoma is described. The presenting symptoms were pain and paraneoplastic signs. The patient did not present hematuria throughout the course of the disease. The urographic, ultrasound and tomodensitometric work up correctly determined tumor size, characteristics and anatomic relationship. Arteriography permitted mapping of the vascular structures of both kidneys. Fine needle aspiration biopsy permitted histologic classification preoperatively. The approach was via a Chevron incision. An extended nephrectomy was performed on the left kidney and surgical enucleation of the tumor in the right kidney in a one stage procedure. The diagnostic aspects are discussed and the therapeutic options are reviewed with special reference to the conservative procedures.