RESUMO
Introducción: el carcinoma de células renales representa entre 90-95 % de los tumores malignos que afectan el riñón, siendo infrecuente su observación asociado a la enfermedad renal poliquística autosómica del adulto. Objetivo: mostrar la asociación de adenocarcinoma renal en una paciente con nefropatía poliquística del adulto de diagnóstico en edad avanzada con escasas manifestaciones clínicas y humorales. Presentación del caso: se presenta el caso clínico de una paciente de 65 años con antecedentes de poliquistosis renal que consulta por aumento de volumen del abdomen constatándose nefromegalia gigante. Se presentan los datos clínicos, humorales, imagenológicos e histológicos que permitieron su diagnóstico. Conclusiones: aunque infrecuente, debe considerarse la posibilidad de adenocarcinoma renal de células claras asociado al riñón poliquístico.
Introduction: the renal cells carcinoma represents between 90-95 % of the malignant tumors that affect the kidney being infrequent its observation associated with the autosomal polycystic kidney disease of the adult. Objetive: to show the association of renal adenocarcinoma in a patient with polycystic nephropathy of the adult of late presentation and with scarce clinical and humoral manifestations. Case Presentation: there appears the clinical case of a 65-year-old feminine patient with precedents of kidney polycystic that it consults of increase of volume of the abdomen being stated nefromegalia giant. The clinical information appears, humoral, imagenoly and histological that allowed its diagnosis. Conclusions: although infrequently should be consider the diagnostic possibility of clear cell renal adenocarcinoma associated to polycystic kidney.
RESUMO
El hipernefroma, tumor de Grawits o tumor del internista por la variedad de formas clínicas que hoy podemos identificar y la diversidad de diagnósticos diferenciales, representa el 3 por ciento de los cánceres en el adulto y del 90 al 95 por ciento de los tumores malignos renales primarios. Casi siempre el diagnóstico es hecho por el internista. A propósito de un caso atendido en nuestra sala de clínica se realiza la presentación del mismo. Se precisan formas clínicas que deben tenerse en cuenta. A nuestro criterio la presentación de casos despierta el interés por el conocimiento en beneficio de su aplicación en nuestra practica clínica diaria. Se acompaña de las imágenes de la TAC, momento operatorio e informe anatomopatológico.
The hypernephroma, Grawits tumor or the internist's tumour for the variety of clinical forms that today we can identify and the diversity of differential diagnoses, it represents a 3 percent of the cancers in the adult and about 90 to 95 percent of the malignant renal primary tumours. It represents the 3 percent of the cancers in the adult of 90 and to the 95 percent of the malignant renal primary tumours. Almost always diagnosis is made by the internist. The presentation of the same one comes true in relation to a case catered to at our clinics hall.. They need clinical forms than the doctor in the making and still the specialists must have in bill. To our opinion the presentation of cases is in the interest for the knowledge of doctors in benefit of the application in our practical daily clinic. Accompanies it an imagery of CAT, operative moment and an anatomopatologic report.
RESUMO
This paper presents some important concepts on renal cancer. Renal cancers origin, incidence, etiology, pathogenesis, histology, clinical presentation, manifestations due to tumor thrombus, manifestations secondary to metastasis, laboratory findings, tumor makers, diagnostic examinations, and differential diagnosis are discussed. The treatment protocol for renal cell carcinoma, from stages I-IV, are also included
RESUMO
Although, renal carcinoma represent 2 to 3% of all human cancers, the impredictable nature, and unique clinical and biological features of renal carcinoma place it among the most interesting of human malignancies. Total surgical excisions offers the only certain cure for nephrocarcinoma, but additional benefit may be achieved by utilization of adjuvantive methods including surgical excision of metastasis, radiation, chemotherapy, and immunotherapy. So, 28 patients with renal cell carcinoma were analyzed retrospectively in order to 1) determine the effectiveness of systemic chemotherapy-hormonal and non-hormonal, 2) identify the clinical features of renal cell carcinoma that may be important in prognosis and 3) characterize the paraneoplastic features of renal cell carcinoma. The classic triad of signs and symptoms including pain, hematuria, and palpable tumor mass presents in only 7%. Paraneoplastic syndrome occurred in up to 28.6% Metastasis was present at diagnosis in 25 % of the cases and developed within 1 year in an additional 10.7%. Surgery was employed to 23 patients for the purpose of complete cure of the disease or palliation and adjuvantive therapy was employed either to palliate symptoms or to attempt eradication of metastatic deposits to 9 patients with or without surgery. Most of metastatic disease was unresponsive objectively to either primary nephrectomy or to a variety of chemotherapy trial. Improving diagnostic capabilities and the introduction of more sophisticated diagnostic equipment promise to provide still earlier identification of patients with renal cell carcinoma and to allow surgical intervention at curable stages of disease.