renal tumor cases for discursion

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RENAL TUMOR RENAL TUMOR CASES FOR DISCURSION CASES FOR DISCURSION Prof. Hasan Farsi Prof. Hasan Farsi Consultant Of Consultant Of Urology Urology KAU KAU Ass Prof Anmar Ass Prof Anmar Nasir Nasir Consultant of Consultant of Urology Urology Um Al-qura univ Um Al-qura univ

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RENAL TUMOR CASES FOR DISCURSION. Ass Prof Anmar Nasir Consultant of Urology Um Al- qura univ. Prof. Hasan Farsi Consultant Of Urology KAU. Case 1. History. Age 54y Symptoms Bilateral flank pain No hematuria No voiding or storage symptoms No uremic manifestations O/E: - PowerPoint PPT Presentation

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Page 1: RENAL TUMOR  CASES FOR DISCURSION

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

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Case 1

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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

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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

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Preop.15/1/2006

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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 :

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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

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Post operative for 2 yrs

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Renal TX 27/11/2008

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Post renal TX

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Case 2

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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

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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 :

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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

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Post op

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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)

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Thank you