Male patient, 59 years old, with a history of chronic obstructive pulmonary disease and right lower lobectomy six months ago for squamous cell carcinoma of the lung (T2N0M0) in the reference center, without having received any treatment
No known allergies or other relevant backgrounds.
The patient presented clinical symptoms compatible with moderate intensity left renal colic with ureteral irradiation, without voiding syndrome and accompanied by hematuria with clot formation.
Located approximately 8 Kgs.
On physical examination, mild muco-percutaneous discomfort and slightly positive left handgrip were observed.
Blurred and depressible abdomen without masses or enlargement.
Rest of the exploration without interest.
The hematological study showed mild anemia, with normal biochemical and coagulation.
Microscopic hematuria is observed in the urine sediment.
Ultrasound showed a cortical cyst in the upper pole of the left kidney of 5 cm in size and a solid-cystic tumor of the same size in the lower pole without ectasia of the excretory pathway.
Right kidney, bladder, and prostate are normal.
The suspicion of renal mass versus complex renal cyst was decided to practice a T.A.C. abscess-minopelvic cyst reporting postoperative changes in the left lung with bilateral emphysema.
Retroperitoneal adenopathies in the territory were more than 1 cm in diameter and heterogeneous renal mass of 5 cm in diameter.
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With these findings and in view of the suspicion of renal carcinoma vs. metastasis, it is decided to perform a directed FNAC CT in which squamous cells of the left kidney are obtained.
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With the diagnosis of left renal metastasis of pulmonary epidermoid carcinoma (Stage IV), we decided to refer the patient to the Medical Ontario Department.
Treatment was initiated with Cisplatin 75 mg./m2 and Vinorelbine 25 mg./m2 on the first and eighth day of every 21 days, to complete 3 cycles, and then perform a response assessment study.
After receiving 3 cycles of chemotherapy with cisplatin-vinorelbin, a slight growth in renal mass was observed and therefore no response was considered.
For this reason, a second line of chemotherapy with docetaxel 100mg/ m2 every 21 days is initiated, which has received 3 cycles.
This pending assessment by means of PET studies and, according to the results, it has been considered that a possible surgical approach to renal lesions should be decided in the event of new pathological foci.
In any case the prognosis is the same as any metastatic lung cancer.
