Managing of Upper Pole Right Renal Mass Using Partial Nephrectomy: Case Report

Abstract

Background: The publishing of improved oncological and functional outcomes over radical nephrectomy has led to a shift in the  management of small renal malignancies toward partial nephrectomy. In order to treat renal cancer, a surgeon would often make an  incision in the patient's abdomen and remove part of the kidney using an open partial nephrectomy. 

Objective: We aimed to assess  efficacy of management of upper pole right renal mass using partial nephrectomy. 

Patient and methods: A female patient 49 years old  housekeeper with no special habits and BMI was 30 kg/m² . She presented to Urology Unit in Al-Ahrar Teaching Hospital with accidently  discovered right upper pole renal mass 6 X 5.5 cm with no other urological symptoms. CT with contrast showed enhanced mass of upper  pole not reaching hilum and normal contralateral kidney with good enhancement. Management done using partial nephrectomy.   

Results: The patient was operated under general anesthesia in left lateral position. Supra 11th rib intercostal incision was done with  complete exposure of the kidney and pedicle control. Pathology showed free margin, and the tumor was confirmed to be an oncocytoma.  

Conclusion: As an alternative to the more thorough open radical nephrectomy (Which removes the entire kidney along with any surrounding lymph nodes, fatty tissue, and adrenal gland) when cancer is present, partial nephrectomy may be considered.  Preoperative radiological pictures made the diagnosis of renal oncocytoma or renal cell carcinoma (RCC) challenging, particularly in cases  where a big mass is visible. Histopathological analysis of the mass was the only way to confirm the diagnosis.