ABSTRACT
INTRODUCTION AND IMPORTANCE: Neoplasms of the Kidney are rarely caused by actinomycetoma or other mycetoma species. Actinomycetoma is a neglected tropical disease which is not uncommon in Sudan. Usually, it is presented as skin and subcutaneous tissue lesions or mass and can affect the bone and other soft tissue. Sites of the lesion are found in lower limbs, upper limbs, head and neck and torso. CASE PRESENTATION: A 55-year-old female presented incidental left renal mass on ultrasound examination from the internal medical department. It is presented as a renal mass mimicking renal cell carcinoma with coexistence with another actinomycetoma brain mass. The histopathology report after nephrectomy confirmed the diagnosis. Patients commenced on anti-actinomycetoma treatment after nephrectomy. CLINICAL DISCUSSION: This is the first reported case in our facility which was diagnosed as a renal actinomycetoma. It was treated by surgical excision and received antibacterial treatments. CONCLUSION: This case demonstrates that renal actinomycetoma can occur in an endemic area even without cutaneous or subcutaneous lesions.
ABSTRACT
Background: Worldwide, renal cell carcinoma comprises 2.2% and 1.8% of global cancer incidence and mortality, respectively. Studies of epidemiology, treatment modalities and outcomes of renal cell carcinoma (RCC) in Sudan are scarce. To address this shortcoming, we evaluated baseline information on the epidemiology, types of treatment and outcomes of RCC at Gezira Hospital for Renal Diseases and Surgery (GHRDS) and the National Cancer Institute (NCI). Methods: We performed a retrospective, descriptive study of all patients with RCC, who were treated in GHRDS and NCI from January 2000 to December 2015. Results: A total of 189 patients with RCC were identiï¬ed over the study period. Tumours were more common among male patients (56%) and involved the left kidney in 52% of cases. The median age at diagnosis was 57 years (range: 21-90 years). Loin pain was the most frequent symptom (n = 103 patients) followed by weight loss (n = 103 patients) and haematuria (n = 65 patients). The most common histopathologic type of RCC was clear cell (73.5%), followed by papillary (13.8%) and chromophobe (1.6%). The relative frequencies of stages I-IV were 3.2%, 14.3%, 29.1% and 53.4%, respectively. The overall median survival rate was 24 months, and the 5-year survival rate was 40%. The 5-year survival rate in stages I-IV was 95%, 83%, 39%, and 17%, respectively. Advanced stages and higher-grade tumour were associated with worse survival. The median survival of stage IV patients was better for patients who underwent nephrectomy (11.0 months) compared to those who did not undergo nephrectomy (4.0 months) (p value = 0.28). Conclusion: Our findings reveal poor outcomes for patients with RCC in Sudan, which is most likely due to the high proportion of patients presenting with advanced stages at the time of initial presentation.
ABSTRACT
INTRODUCTION: Renal tuberculosis (RTB) has no specific presentation and symptoms can be absent in up to 8% of cases in developing countries. Most patients present with symptoms like fever, burning micturition, pyuria, weight loss, and loin pain. In very rare occasions RTB can present as a renal mass mimicking renal cell carcinoma RCC. CASE REPORT: We report a case that was initially diagnosed as renal cell carcinoma and histopathology revealed renal tuberculosis. DISCUSSION: Tuberculosis is more common than renal cell carcinoma, the WHO states that 1 in every three individuals have TB worldwide, but something to keep in mind is that the incidence of RCC is increasing by the rate of 1% since the year 2006. Hence uncommon presentations of common diseases are more common than common presentations of uncommon diseases, then when doctors encounter a patient who is presenting with renal mass especially in countries that are endemic with TB a probability of uncommon presentation of UGTB should be considered to avoid missing the chance of treating a medically curable condition. Most of the reported cases in the literature about pseudo tumor presentation of UGTB indicate that most of the cases presented with unilateral mass mimicking RCC and TB is detected after radical nephrectomy. CONCLUSION: RTB can mimics RCC clinically and radiologically, which creates a diagnostic challenge. The chance of diagnosing renal TB in a patient presenting with renal mass is extremely lower than the chance of missing it for RCC, this because of the lack of evidence-based diagnostic approaches.
