A 52-year-old male with a history of arterial hypertension (AHT), type I diabetes mellitus, ESRD secondary to diabetic nephropathy and on dialysis for 5 years, who had been under pretransplantation for months.
During a review by nephrology, an incidental diagnosis is made by abdominal ultrasound of decreased kidneys of size and mass of solid characteristics in the upper pole of the right kidney of 31x29 mm that compresses the renal sinus.
That is why he is referred to the urology service for evaluation.
A computed tomography (CT) of the largest abdominal region was requested during the study by the urology service, which showed the presence of two solid nodules in the upper right renal pole measuring about 3 cm.
They showed solid, isodense, well circumscribed features.
No lymph node, perirenal fat or renal vein involvement was observed.
Both kidneys also showed a decrease in contrast uptake in relation to ESRD.
1.
These findings were treated surgically by right radical nephrectomy, which was uneventful, as well as postoperatively.
In the anatomopathological study of the specimen after surgery there are two lesions of 3x3 cm and 1.5x1 cm in the upper pole of the kidney, which from the macroscopic point of view are homogeneous, with brownish capsule necrosis, well delimited
Microscopically, these two masses reveal large, rounded and uniform cells, with a small nucleus and uniformly distributed chromatin, without atypia, adopting a nest pattern.
There are also multiple onychocytic lesions in a broad morphological spectrum that include: oncocytoid changes in the renal tubules; microeosinophilized by mixed cells; non-severe lymphocytic infiltrate with diffuse interstitial thickening; and interstitial infiltrate.
Important tubular.
In the immunohistochemical study staining with cytokeratins 8 and 18 was positive and reaction with vimentin was negative.
Therefore, two OR accompanied by microscopic OCR are diagnosed.
Given the benign characteristics of the diagnosed neoplasms, the patient is reintroduced into a waiting list for renal transplantation after the postoperative period.
Nine months later, a kidney and pancreas transplant was performed, and the intervention and postoperative period were uneventful.
In subsequent follow-up, every three months for three years, there was no recurrence of OCR or any tumor in the contralateral kidney, maintaining good graft function.
