renal tumor cases for discursion prof. hasan farsi consultant of urology kau ass prof anmar nasir...
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RENAL TUMOR RENAL TUMOR CASES FOR DISCURSIONCASES FOR DISCURSION
Prof. Hasan FarsiProf. Hasan FarsiConsultant Of UrologyConsultant Of Urology
KAUKAU
Ass Prof Anmar NasirAss Prof Anmar NasirConsultant of UrologyConsultant of Urology
Um Al-qura univUm Al-qura univ
Case 1
HistoryHistory AgeAge
– 54y54y SymptomsSymptoms
– Bilateral flank pain Bilateral flank pain – No hematuriaNo hematuria– No voiding or storage symptoms No voiding or storage symptoms – No uremic manifestationsNo uremic manifestations
O/E:O/E:– Generally okGenerally ok– Fullness in both renal angle with mild Fullness in both renal angle with mild
tenderness tenderness – no palpable mass no palpable mass
Laboratory profilesLaboratory profilesCBCCBCRenal profilesRenal profiles
HgHgWbcsWbcsPlateletPlateletCrCrNaNaKK
PropProp1481485.75.723123180801381384.04.0
Post OpPost Op105105-143-1431313350350738-1018738-1018128-140128-1403.1-6.63.1-6.6
Post Renal Post Renal TXTX
1061065.75.73213211081081341343.93.9
AlbuminAlbuminAlk PhosAlk PhosBilirubinBilirubinAltAltCxrCxr
PropProp4242575710101515NadNad
Post OpPost Op41415858881919NadNad
Post Post Renal Renal TXTX
35354747772424NadNad
Preop.15/1/2006
Surgical procedureSurgical procedure
Date :Date :– 23/2/200623/2/2006
Surical techniqueSurical technique– Bilateral radical nephrectomyBilateral radical nephrectomy– 12 rib supra costal approch12 rib supra costal approch
Pathology :Pathology :
PathologyPathology
Gross DescriptionGross DescriptionMicroscopic DescriptionMicroscopic Description
Left Left Right Right Left Left RightRight
SizeSize17x11x617x11x614x7x614x7x6GII T2NoMoGII T2NoMoGIIT2NoMoGIIT2NoMo
Attached ToAttached ToPre-nenphric Fat, Pre-nenphric Fat, Ureter And Ureter And
Renal Artery Renal Artery And VeinAnd Vein
Ureter And Ureter And Renal Renal
Artery And Artery And VeinVein
Adrenal Adrenal GlandGland
+Ve+Ve-Ve-Ve
LNLN-Ve-Ve-Ve-Ve
Tumour Tumour Numerous Tumor Numerous Tumor Nodules Nodules
Ranging In Ranging In Sixe From0.4-Sixe From0.4-
9cm9cm
Numerous Numerous Tumor Tumor Nodules Nodules
Ranging In Ranging In Sixe Sixe
From0.4-From0.4-6cm6cm
Post operative for 2 yrs
Renal TX 27/11/2008
Post renal TX
Case 2
Case 2Case 2 AgeAge
– 53y53y SymptomsSymptoms
– Left flank pain Left flank pain – No hematuriaNo hematuria– No voiding or storage symptoms No voiding or storage symptoms – No uremic manifestationsNo uremic manifestations
O/E:O/E:– Generally okGenerally ok– mild tenderness mild tenderness – no palpable massno palpable mass
Surgical procedureSurgical procedure
Date :Date :– 8/5/20078/5/2007
Surical techniqueSurical technique– Left partial NephrectomyLeft partial Nephrectomy– 12 rib supra costal approch12 rib supra costal approch
Pathology :Pathology :
PathologyPathology
Gross DescriptionGross DescriptionMicroscopic DescriptionMicroscopic Description
Left Left
Left Left GII T3NoMoGII T3NoMo
SizeSize3.5x2.5x13.5x2.5x1
Tumour Tumour Well circumscribed Well circumscribed Submitted Submitted
total+safty margin total+safty margin from the bed from the bed
Post op
Surgical procedureSurgical procedure
Technique:Technique:– left renal explorationleft renal exploration– 12 rib incision12 rib incision– Excision of mass in the left renal bed Excision of mass in the left renal bed
with safety margin from including the with safety margin from including the renal capsulerenal capsule
– Pathology:Pathology:Myofibroblastic proliferation (Desmoid Myofibroblastic proliferation (Desmoid
tumor)tumor)
Thank you