This is a 70-year-old patient who complains of lower urinary tract symptoms in the form of onset of increased nocturnal micturition frequency, slight dysuria, as well as a slight decrease in voiding caliber.
This incipient prostatic symptomatology refers to its zone urologist, who performs a rectal examination (adenoma II), and requests PSA determination and abdominal ultrasound for the following consultation.
The patient had only a history of left eye surgery due to trauma, and in the urologic plane a lulithectomy of the upper third of the ureter 35 years ago at another center.
In the following consultation, and when the patient is completely asymptomatic, the ultrasound study determines the existence of a parahilar mass in the left kidney of about 6 cm in diameter, a normal right kidney c PSA, a prostate c.
CT is performed with the result of a left parapyelic image of 5-6 cm in diameter, of solid appearance, extending from the renal hilium to a calcified renal cell.
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With the diagnosis of renal mass an extension study is performed that is negative, considering the surgical revision and excision of the mass and/or nephrectomy according to findings.
Fifteen days later a left lumbotomy was performed.
Once the renal dissection maneuvers are initiated, the mass is clearly identified compressing the kidney, but with a clear plane of dissection between them.
Given the doubts about the nature of the mass, an intraoperative biopsy is performed to obtain textile fibers.
Established evidence that a gauze was in front of the previous intervention, exeresis of the entire tumor was performed preserving the renal unit.
Once the mass is removed, it is opened and fragments of tapered gas are found inside, with material of caseous aspect around it.
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Anatomopathological analysis of the tumor wall showed hyaline material with tendency to collagenization, and inflammatory reaction especially to histiocytes.
