Adenocarcinoma renal injertado en riñón poliquístico. Presentación de un caso / Renal adenocarcinoma implanted in kidney polycystic. Case presentation

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.

Caracterización de pacientes con adenocarcinoma renal / Characterization of patients with renal adenocarcinoma

Introducción: el adenocarcinoma renal se considera una de las neoplasias más letales entre los cánceres urológicos. Objetivo: caracterizar a los pacientes atendidos por adenocarcinoma renal, con énfasis en aspectos del diagnóstico, el tratamiento y el pronóstico de vida. Métodos: se realizó un estudio descriptivo de los pacientes atendidos por adenocarcinoma renal, desde enero de 1996 hasta diciembre de 2005. Las variables estudiadas fueron: edad, sexo, síntomas y signos, estudios imaginológicos, tamaño de la lesión/estadio tumoral, modalidades terapéuticas empleadas, complicaciones derivadas de estas y la sobrevida a los 5 años del tratamiento. Resultados: en la serie de 94 pacientes prevaleció el grupo de edad de 50-59 años con 41 pacientes (43,6 por ciento); el sexo masculino fue el más afectado con 66 casos (70,2 por ciento); preponderó el diagnóstico incidental en 46 pacientes (48, 9 por ciento); el ultrasonido se empleó en la totalidad de los casos y fue positivo en el 98,9 por ciento; predominaron las lesiones en el estadio I en 49 pacientes (52,1 por ciento); la modalidad terapéutica más empleada fue el tratamiento quirúrgico en 88 pacientes (93,6 por ciento) y de esta, la nefrectomía por vía lumbar se le practicó a 59 pacientes (67,0 por ciento). El 69,3 por ciento de los pacientes no tuvo complicaciones. La sobrevida a los 5 años fue de 97,9 por ciento. Conclusiones: el diagnóstico incidental del adenocarcinoma renal se favorece por la pesquisa en grupos de riesgo, sintomáticos o no, con el empleo del ultrasonido abdominal. Esto trae aparejado el tratamiento quirúrgico oportuno en estadios precoces y la mejoría significativa del pronóstico de vida

Introduction: the renal adenocarcinoma is considered as one of the more lethal neoplasias among urologic cancers. Objective: to characterize the patients treated due to renal adenocarcinoma emphasizing the diagnostic features, the treatment and the life prognosis. Methods: a descriptive study was conducted of patients cared due to renal adenocarcinoma from January, 1996 to December, 2005. Study variables included: age, sex, symptoms and signs, imaging studies, lesion size/tumor stage, therapeutical modalities used, complications derived from these and survival at 5 years of treatment. Results: in series of 94 patients there was predominance of 50-59 age group with 41 patients (43.6 percent); the male sex was the more involved one with 66 cases (70.2 percent) as well as the incidental diagnosis in 46 patients (48.9 percent; ultrasound (US) was used in all the cases and it was positive in the 98.9 percent and predominance of stage I lesions in 49 patients (52.1 percent); the more used therapeutical modality was the surgery in 88 patients (93.6 percent) including the lumbar route nephrectomy carried out in 59 patients (67.0 percent). The 69.3 percent of patients have not complications. The 5-years survival was of 97.9 percent. Conclusions: the incidental diagnosis of renal adenocarcinoma is favored by the screening in risk groups, symptomatic or not, using the abdominal US. This is linked with a timely surgical treatment in early stages and the significant improvement of life prognosis

Clinical Observation of Renal Adenocarcinoma / 대한비뇨기과학회지

The clinical observation was made on 34 cases of renal adenocarcinoma in Department of Urology, Yonsei University College of Medicine, during the period from 1970 to 1980 (June). 1) Male to female ratio was 1.8:1, and the age distribution showed that the high peak incidence were fifth decade or later. 2)Chief complaints of its patients were palpable mass(64.7%), hematuria(61.8%), and flank pain(35.3%). 3) Left to right ratio of renal adenocarcinoma was 1.6:1, and 57.1% of the cases were developed in the upper portion of kidney, 35.7% in the lower portion, and 7.2% in the middle portion. 4) The cell types of renal adenocarcinoma showed that 75% of all the cases were clear cell type, 20% in granular cell type, and 5% in spindle cell type. The mean weight of nephrectomized kidney with renal adenocarcinoma was 680 gram. 5) The clinical stage coincided with final stage in 73% of all cases, and the accuracy of clinical staging in stage I and stage III was lower. 6) In the stage VI cases of renal adenocarcinoma, 60% of these cases were metastased to lung at the diagnosed period, 50% to bone, 40% to liver and 20% to lymph nodes except the regional area of affected kidney.

A Clinical Observation on Adenocarcimoma of the Kidney / 대한비뇨기과학회지

A clinical observation was made on 25 cases of renal adenocarcinoma admitted to the Department of General Surgery and Urology, National Medical Center, Seoul, Korea, during the period from January. 1963 to December. 1977. The following results were obtained : 1) The range of age was from 25 to 66. The most prevalent age group of renal adenocarcinoma was 50 to 59 (36%). The male and female ratio was 1.8 : 1. 2) 6 cases or 248 of 25 cases visited to hospital from one to six months after the occurrence of initial disturbance and 5 cases from 1 year to 2 years. 3) Among the symptoms on admission, hematuria was in 15 cases (60%), mass in 10 cases (40%) and flank pain in 7 cases (28%) 4) On the physical examination, abdominal mass was in 13 cases (52%), abdominal tenderness in 9 cases (36%) and hypertension in 8 cases (32%). On the laboratory examination, anemia was in 9 cases (36%), erythrocytosis in 2 cases and elevation of ESR in 8 cases (32%) 5) On the urograms , the non-visualization of the kidney was found in 6 cases (20%) and poor visualization in 7 cases (28%), Flattening , elongation, narrowing, and irregular filling defect of the pelviocalyces were found in 9 cases (36%) while elongation of one or more calyces noted in 2 cases . 6) The degree of vascularity on angiography revealed avascularity in 1 case, minimal vascularity in 2 cases, moderate vascularity in 3 cases and marked vascularity in 19 case (76%). 7) The right kidney was involved in 12 cases and left kidney in 13 cases. The upper pole was involved in 9 cases (36%), lower pole in 7 cases (28%), midportion in 4 cases and diffuse involvement was 5 cases. 8) The pathological staging was done in 22 of 25 cases. The Results revealed stage I in 5 cases, stage II in 2 cases, stage III in 6 cases and stage IV in 9 cases. 9) The histological type of 20 cases revealed clear cell in 10 cases, granular cell in 4 cases and mixed variety in 6 cases. 10) There were 4 cases of lung metastasis which were the most common metastatic involvement and 2 cases of vone metastasis. 11) Nephrectomy was performed on 18 cases, combined treatment with nephrectomy and chemotherapy was undergone in 2 cases and palliative treatment in 5 cases. 12) 1-year survival rate was 43.1%(7/16) and 5-year survival rate 7.7%(1/13).