A 67-year-old male with a history of hypertension, dyslipidemia, obstructive cardiomyopathy, and obstructive sleep apnea syndrome.
Chronic renal failure due to nephroangiopathy was established in 1998 without incidents.
The patient had a normal functioning graft (serum creatinine 2.4 mg/dL at baseline) and was treated with Prednisone and Cyclosporine A (CsA).
In 2006, a lesion was detected in the lower lip that was excised, with the anatomopathological result of microinfiltrating epidermoid carcinoma.
The situation of CsA due to Tacrolimus changed immunosuppression.
In May 2007, a solid mass in the anterior cortex, in the upper middle zone, approximately 3 cm in diameter, was detected in routine ultrasound.
The patient is asymptomatic and with preserved graft function.
A confirmatory CT scan showed a solid focal lesion in the upper middle zone of the anterior side of the graft.
After aspiration puncture confirming the lesion as renal cell carcinoma, it was decided to perform nephron sparing surgery due to the good functionality of the graft and the favorable characteristics of the lesion.
Under cold ischemia and intraoperative ultrasound control, partial nephrectomy with intraosseous approach is performed, sending a tumor bed for intraoperative pathological analysis that confirms the negativity of surgical margins.
The final result of the analysis confirmed a renal cell carcinoma stage pT1 G1, completely removed.
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The evolution of the patient is satisfactory, presenting a slight increase in creatinine to 4.2 mg/dl with recovery from baseline at the fifth postoperative day.
Currently, after a 14-month follow-up, the patient is asymptomatic and there are no data of tumor recurrence or distant metastases.
Graft function was stable with a creatinine level of 2.3 mg/dl. Previous immunosuppression with Prednisone was maintained, and Sirmus was maintained.
