BACKGROUND: Renal preservation in selected patients with upper-tract urothelial cancer (UTUC) has been well described, offering an alternative to radical nephroureterectomy.
We present our experiences in performing percutaneous treatments after neoadjuvant chemotherapy in one such patient with a large, complex, high grade UTUC in a solitary kidney.
CASE REPORT: A 55 year old female with a solitary kidney presented with a 5.2 cm enhancing mass with calcifications involving the left renal pelvis and lower pole. Cystoscopy and retrograde pyelography demonstrated normal bladder mucosa. Ureteroscopy revealed a large, papillary tumor occupying the renal pelvis. Ureteroscopic treatment was deemed impossible due to the lesion's volume. We proceeded with percutaneous resection after downsizing the tumor after a course of neoadjuvant chemotherapy. Using a 25 F resectoscope via a percutaneous tract, resection was performed to fully excise the tumor , and the patient received 2 postoperative chemotherapy courses. This patient developed a recurrence within an isolated calyx 8 months post operatively which was also managed percutaneously.
CONCLUSION: A multimodal approach in a highly motivated patient could represent a reasonable strategy for patients in whom such a therapy is desired.
Written by:
Williams SK, Atalla C, Ghavamian R, Stein CA, Hoenig D. Are you the author?
UNiversity of Miami, Urology, 1400 NW 10th Avenue, Suite 507, Miami, Florida, United States, 33136.
Reference: J Endourol. 2013 Feb 26. Epub ahead of print.
doi: 10.1089/end.2012.0521
PubMed Abstract
PMID: 23442142
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UroToday.com Upper Tract Tumors Section
