Survival of patients with bilateral renal cell cancer after nephro-preserving surgery

This article presents a systematic literature review to assess the survival outcomes of patients with bilateral renal cell carcinoma who underwent nephro-preserving surgery. Patients with bilateral renal neoplastic lesions represent a rare subpopulation, numbering, according to different authors, from 2 to 6 % of the total RCC group. Despite the increase in the number of cases of bilateral RCC, the number of works devoted to the study of the features of surgical intervention, prognosis factors, treatment outcomes and survival of this cohort of patients is limited, and a number of important questions regarding this problem remain unresolved. Currently, the only effective method of treating bilateral renal cancer is nephro-preserving surgery in the volume of bilateral renal resection / nephrectomy with resection of the contralateral kidney in case of synchronous lesion or resection of a single kidney in case of metachronous lesion. This strategy avoids or reduces the risk of developing renal failure and its consequences after surgery. Conclusion. Nephro-preserving surgery for bilateral renal cell carcinoma is the only effective method to achieve satisfactory oncological results with a low incidence of complications.

Adrenal gland as a target of synchronous and metacronous metastasis from renal cell carcinoma: results of surgical treatment in a single institution

Background. Surgical treatment of solitary and oligometastatic metastases in renal cell carcinoma (RCC) is one of the treatment options for modern oncology.The objective of study to compare surgical outcomes in treatment of synchronous and metachronous solitary metastatic adrenal tumors in RCC.Materials and methods. The study included 93 patients with kidney cancer, from 1997 till 2018, who underwent surgical treatment in the urological oncology department of the P.A. Hertzen Moscow Oncology Research Institute. The 1st group is represented by 58 patients with RCC and synchronous secondary adrenal gland lesion, who underwent simultaneous surgery, consist of radical nephrectomy and adrenalectomy without subsequent adjuvant therapy. The 2nd group included 35 patients with metachronous solitary metastatic adrenal gland lesion who underwent surgical treatment.Results. The progression of disease to left adrenal gland was observed in 40 (43.0 %) cases, to the right – in 39 (41.9 %), both adrenal glands — 14 (15.1 %) cases. The median diameter of the adrenal tumors was 44 (4—170) mm, the most common in both groups were tumors less than 5 cm (58.1 %). The sensitivity of ultrasound in the diagnosis of adrenal tumors was 80.6 %, computed tomography – 93.5 %, adrenal biopsy – 73.9 %. The median of the observation time was 42 months (1st group — 24 months, 2nd group – the median was not achieved). The one-year survival of patients with a metachronous lesion of adrenal was 82.3 ± 76.6 % versus 52.8 ± 7.1 % in the synchronous lesion group, three-year survival was 79.2 ± 7.0 % versus 32.3 ± 7.6 % and five-year – 57.0 ± 10.0 % versus 16.2 ± 12.0 %, respectively. In multivariate analysis, only a metachronous lesion is a factor of favorable prognosis (p = 0.002).Conclusion. Surgical treatment for metachronous adrenal gland metastatic lesions is appropriate intervention and provides better patient survival rates compared to synchronous lesions.

Metachronous inflammatory myofibroblastic tumour in the temporal bone: case report

Objective:We report an extremely rare case of metachronous inflammatory myofibroblastic tumour in the temporal bone.Method:Case report and review of the world literature on metachronous inflammatory myofibroblastic tumour.Results:Inflammatory myofibroblastic tumour in the temporal bone is rare, and metachronous inflammatory myofibroblastic tumour in the temporal bone has never been reported in the English medical literature. We report a case of inflammatory myofibroblastic tumour in the right temporal bone in a 27-year-old woman presenting with right-sided otalgia and progressive hearing loss. A metachronous lesion was discovered in the left temporal bone one year later. The patient underwent surgical excision of the tumour via canal wall down mastoidectomy for both lesions. Long term steroids were prescribed after both surgical procedures. At follow up three years after the last procedure, the patient remained free of disease.Conclusion:To the best of our knowledge, this is the first reported case of metachronous inflammatory myofibroblastic tumour in the temporal bone.