A 78-year-old male with no relevant medical or surgical history.
In a study in urology clinics for low back pain of 6 months of evolution with associated hematuria.
The examination highlights left renal percussion; with respect to complementary laboratory tests normal blood, mild urinary sediment microhematuria nonspecific urinary cytology.
Ultrasound showed left kidney bilobulated mass of 5 cm maximum diameter, mesorenal.
CT scan revealed a left mesorenal mass with a protrusion in the sinus of 6 cm of maximum diameter, an infrarenal aortic aneurysm of 5 cm in diameter that extended to the bifurcation of the iliac metastases; there was no evidence of intraabdominal metastases.
1.
With the diagnosis of renal tumor and abdominal aortic aneurysm, open laparotomy was performed with aneurysm correction and placement of PTFE prosthesis, left nephrectomy with ureter resection until iliac crossing.
The pathology report reports Kidney with two tumors.
A high-grade papillary and solid urothelial carcinoma of the pelvis and renal cavities with superficial extension but without affecting the pelvic muscle layer or renal parenchyma; pT1 stage (CCm)
A papillary renal cell carcinoma with low grade UI changes (Fuhrman 2), limited to the parenchyma, without involvement of the excretory or venous system; stage pT1b G2
Given the patient's age, free ureteral margins without dysplasia, a delayed resection was not performed.
One year after surgery the patient is asymptomatic and without cancer recurrence.
