V.P.C. 66-year-old male with a history of hypercholesterolemia, hypertension, former smoker for 4 years and erectile dysfunction.
She was admitted to the emergency department due to deterioration of her general condition.
The examination is anodyne and no significant cutaneous stigma is observed.
Abdominal ultrasound showed a heterogeneous hypoechogenic mass in the upper pole of the left kidney.
The CT scan showed a hypodense, polylobular mass of about 11 cm in diameter, located in the upper pole of the left kidney.
Perirenal fat is affected but not locoregional lymph nodes.
Blood and urine analytical studies were normal.
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An expanded left renal nephrectomy was performed by anterior approach, extra and mass of considerable size.
The anatomopathological study describes a tumor whose dimensions are 12.5 x 9.5 x 9.5 cm, located in the renal capsule but not in the parenchyma or the excretory pathway of the kidney.
Aposta seizure se observant fusiformes cells with certain nuclear pleomorphism.
Immunohistochemical study is positive for Vimentin S-100, as well as neurospecific Enolase, all compatible with malignant Schwannoma, which in this case is located in the retroperitoneum.
During follow-up, the patient had a stroke due to right temporal ischemic infarction without sequelae.
A control CT scan at 2 years showed thickening of the anterior gastric wall which after upper endoscopy and biopsy was diagnosed with gastric adenocarcinoma and subsequently underwent subtotal gastrectomy.
Four years after nephrectomy, and after controls with TAC, the patient does not present, so far, residual disease in the surgical bed or metastatic disease, being free of disease.
