A 60-year-old woman underwent left laparoscopic radical nephrectomy for a renal tumor of the lower pole, of 9.7x7.5 cm. In the intervention there were peritumoral adhesions to the paraaortic clip and to the distal urcolon 100 vessels.
The anatomopathological study showed clear cell renal carcinoma, solid and cystic, with areas of intratumoral bleeding, Fuhrman grade 2-3, stage pT2 pN0.
The postoperative period was uneventful, with a decrease in hemoglobin of 1.5 g/dl (from 13.2 to 11.7), and the patient was discharged after five days.
One month after discharge, the patient complained of increased abdominal perimeter that caused dyspnea and discomfort. Imaging studies showed diffuse ascites, suggestive of chylous ascites.
Analyses showed Hb 11.1 g/dl, leukocyte formula and normal lymphocyte count, normal renal and hepatic function and mild hypoproteinemia - albumin 2.9 g/dl (N: 3.4-5), total protein of 6.4-dl2).
She was treated conservatively, without performing diagnostic or evacuative paracentesis, with a low-fat diet and lipid supplements proteinase at hospital after six days, with complete abdomen healing at 50 mg/day, and improvement in symptoms and abdominal perimeter.
Six months later she has no symptoms or signs of recurrence, and abdominal ultrasound is normal.
