Search

El 10-15 % de los tumores renales son tipo papilar, su asociacion a sindromes hereditarios es poco frecuente y son muy agresivos. Se presenta el caso de un paciente con piloleiomiomatosis con tumor dependiente del rinon derecho y la glandula suprarrenal izquierda, y nefrectomia radical derecha con carcinoma renal papilar tipo 2. Recurrencia retroperitoneal, hepatica y lesion testicular bilateral. Orquiectomia radical izquierda con tumor de celulas de Leydig, metastasectomia hepatica y retroperitoneal con carcinoma papilar tipo 2, ultimo estudio de seguimiento sin datos de actividad tumoral. el seguimiento oncologico con estudios no invasivos y los avances terapeuticos pueden mejorar las tasas de supervivencia. 10-15% of cases of renal tumors correspond to papillary type, the association to hereditary syndromes is rare, and aggressive. Clinical case: male with a history of piloleiomyomatosis and right kidney and left adrenal tumor, right radical nephrectomy with papillary renal carcinoma type 2. Development retroperitoneal, hepatic and bilateral testicular tumor. Left radical orchiectomy with Leydig cell tumor, hepatic and retroperitoneal metastasectomy with papillary carcinoma metastasis type 2, latest follow-up study without tumor activity. Oncological follow-up with non-invasive studies and therapeutic advances could improve survival rates.

Background Nephron-sparing surgery is currently the treatment of choice for surgical removal of solid renal tumours smaller than 7 cm, in the case of a solitary kidney, bilateral renal tumours or the presence of chronic renal failure. Material and methods An observational, descriptive, retrospective and cross-sectional study was conducted. The variables evaluated were: age at diagnosis, gender, intraoperative blood loss, operative time, preoperative tumour size, hospital stay, pathology report, pTNM classification, Fuhrman nuclear grade, pre- and post-operative creatinine, monitoring for cancer. All were analysed using SPSS v 22. Results The study included 28 patients, 14 male and 14 women, with a mean age 52.3 years. The approach was lumbotomy in all patients. The mean hospital stay was 4.1 days. Mean perioperative bleeding loss was 380.3 ml. The mean preoperative creatinine was 0.96 mg/dl, with a post-operative mean of 1.12 mg/dl. Histopathology reported, 23 clear cell tumours, 2 angiomyolipomas, 2 oncocytomas, and 1 haemorrhagic cyst. Tumour staging was performed on 14 patients, with 13 patients T1bN0M0, and 1 patient T2aN0M0. In clear cell tumours, Fuhrman nuclear grade 2 was present in 16 patients and 7 patients were Fuhrman grade 3. Conclusion Nephron sparing surgery is the choice procedure of choice in patients with small renal tumours, with good functional results without significant alteration in renal function. Outcome is optimal, with a low incidence of complications.

Nephron -sparing surgery is currently the treatment of choice for surgical removal of solid renal tumours smaller than 7 cm, in the case of a solitary kidney, bilateral renal tumours or the presence of chronic renal failure.An observational, descriptive, retrospective and cross-sectional study was conducted. The variables evaluated were: age at diagnosis, gender, intraoperative blood loss, operative time, preoperative tumour size, hospital stay, pathology report, pTNM classification, Fuhrman nuclear grade, pre- and post-operative creatinine, monitoring for cancer. All were analysed using SPSS v 22.The study included 28 patients, 14 male and 14 women, with a mean age 52.3 years. The approach was lumbotomy in all patients. The mean hospital stay was 4.1 days. Mean perioperative bleeding loss was 380.3 ml. The mean preoperative creatinine was 0.96 mg/dl, with a post-operative mean of 1.12 mg/dl. Histopathology reported, 23 clear cell tumours, 2 angiomyolipomas, 2 oncocytomas, and 1 haemorrhagic cyst. Tumour staging was performed on 14 patients, with 13 patients T1bN0M0, and 1 patient T2aN0M0. In clear cell tumours, Fuhrman nuclear grade 2 was present in 16 patients and 7 patients were Fuhrman grade 3.Nephron sparing surgery is the choice procedure of choice in patients with small renal tumours, with good functional results without significant alteration in renal function. Outcome is optimal, with a low incidence of complications.