Nephron-sparing surgery in multiple renal cancer: a case report

BACKGROUND: In the last decade, nephron-sparing surgery has largely supplanted the radical approach for the treatment of small renal masses. More recently, ablative technologies have been discussed as alternative in patients that are not eligible for surgical approach.CASE SUMMARY: A 54-year-old Caucasian man was referred to our Urology Clinic for multiple renal masses. A computed tomography (CT) scan revealed three contrast-enhanced lesions located in the upper pole, middle renal, and in the lower pole of the left kidney 20 mm, 25 mm, and 45 mm long, respectively. The patient underwent laparoscopic tumorectomy of two lesions and cryoablation of the left renal mass by the transperitoneal approach, performed without clamping the renal vessels. At the end of the procedure the operator posed a reno-ureteral ipsilateral stent to tutor the urinary tract. Tumor enucleation and cryoablation were chosen to preserve renal function.CONCLUSION: This case report shows that in young patients with multiple renal tumors, cryoablation treatment is feasible and outcomes are promising as well. However, risk of complications should be considered and discussed with patients.

Multiple Bilateral Renal Angiomyolipomatosis in Patients with Tuborous Sclerosis

Angiomyolipomas are benign hamartomatous lesions which occur mainly in the kidneys. They often arise in middle aged women and they most commonly present as solitary tumours of varying size, symptomatic or asymptomatic. They may also be found incidentally on sonography, CT or at autopsy. In 20% of the cases they coexist which CNS and skin lesions, thus presenting as tuberous sclerosis syndrome. In 80% of cases of tuberous sclerosis they are found as bilateral, multiple renal masses with or without renal cystic disease.