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A case report of one of the largest {3.63 kg} renal tumour removed in the Western Hemisphere. A combined Uro vascular approach for complete removal
INTRODUCTION: This paper describes the technique employed for the removal of the largest renal tumour in the Western Hemisphere and the second largest in the World. It is a road map for Surgeons in Training and should be of interest to other Surgeons/Urologists. This tumour weighed 3.63 kg; the worl...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909724/ https://www.ncbi.nlm.nih.gov/pubmed/27284761 http://dx.doi.org/10.1016/j.ijscr.2016.05.036 |
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author | Sawh, L.R. Budhooram, Steve Ewe, Peng Rattan, Ryan Sawh, Sean L. |
author_facet | Sawh, L.R. Budhooram, Steve Ewe, Peng Rattan, Ryan Sawh, Sean L. |
author_sort | Sawh, L.R. |
collection | PubMed |
description | INTRODUCTION: This paper describes the technique employed for the removal of the largest renal tumour in the Western Hemisphere and the second largest in the World. It is a road map for Surgeons in Training and should be of interest to other Surgeons/Urologists. This tumour weighed 3.63 kg; the world's largest weighed 5.44 kg. PRESENTATION OF CASE: A 52 year old male presented with a one year history of progressive weight loss, a gradually enlarging abdomen and no other admissible symptom, including no haematuria. The mass started on his left side of the abdomen. CT scans showed a large tumour arising from the left kidney. DISCUSSION: A combined Urological and vascular approach was chosen in view of the CT scans images of huge renal veins and collateral vessels. The left pleural cavity was elevated by the mass pushing on the left diaphragm and the heart was also displaced cranially as the mass made its own space. Bowels were displaced as the giant mass reached into his pelvis. A thoraco abdominal supra12 rib bed approach was adopted. The rib was not resected nor was the pleural cavity opened. Histological diagnosis was renal leiomyosarcoma. CONCLUSION: Large renal tumours or masses are best approached by the Urologist with an experienced vascular/general surgeon as assistant as well as a skilled anesthetist/Intensivist. Optimisation, critical care and early mobilization of the patient by a dedicated nursing staff are essential to minimize complications and ensure a successful end result. The success of this operation underscores what is possible in developing countries. |
format | Online Article Text |
id | pubmed-4909724 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-49097242016-06-21 A case report of one of the largest {3.63 kg} renal tumour removed in the Western Hemisphere. A combined Uro vascular approach for complete removal Sawh, L.R. Budhooram, Steve Ewe, Peng Rattan, Ryan Sawh, Sean L. Int J Surg Case Rep Case Report INTRODUCTION: This paper describes the technique employed for the removal of the largest renal tumour in the Western Hemisphere and the second largest in the World. It is a road map for Surgeons in Training and should be of interest to other Surgeons/Urologists. This tumour weighed 3.63 kg; the world's largest weighed 5.44 kg. PRESENTATION OF CASE: A 52 year old male presented with a one year history of progressive weight loss, a gradually enlarging abdomen and no other admissible symptom, including no haematuria. The mass started on his left side of the abdomen. CT scans showed a large tumour arising from the left kidney. DISCUSSION: A combined Urological and vascular approach was chosen in view of the CT scans images of huge renal veins and collateral vessels. The left pleural cavity was elevated by the mass pushing on the left diaphragm and the heart was also displaced cranially as the mass made its own space. Bowels were displaced as the giant mass reached into his pelvis. A thoraco abdominal supra12 rib bed approach was adopted. The rib was not resected nor was the pleural cavity opened. Histological diagnosis was renal leiomyosarcoma. CONCLUSION: Large renal tumours or masses are best approached by the Urologist with an experienced vascular/general surgeon as assistant as well as a skilled anesthetist/Intensivist. Optimisation, critical care and early mobilization of the patient by a dedicated nursing staff are essential to minimize complications and ensure a successful end result. The success of this operation underscores what is possible in developing countries. Elsevier 2016-05-25 /pmc/articles/PMC4909724/ /pubmed/27284761 http://dx.doi.org/10.1016/j.ijscr.2016.05.036 Text en © 2016 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Sawh, L.R. Budhooram, Steve Ewe, Peng Rattan, Ryan Sawh, Sean L. A case report of one of the largest {3.63 kg} renal tumour removed in the Western Hemisphere. A combined Uro vascular approach for complete removal |
title | A case report of one of the largest {3.63 kg} renal tumour removed in the Western Hemisphere. A combined Uro vascular approach for complete removal |
title_full | A case report of one of the largest {3.63 kg} renal tumour removed in the Western Hemisphere. A combined Uro vascular approach for complete removal |
title_fullStr | A case report of one of the largest {3.63 kg} renal tumour removed in the Western Hemisphere. A combined Uro vascular approach for complete removal |
title_full_unstemmed | A case report of one of the largest {3.63 kg} renal tumour removed in the Western Hemisphere. A combined Uro vascular approach for complete removal |
title_short | A case report of one of the largest {3.63 kg} renal tumour removed in the Western Hemisphere. A combined Uro vascular approach for complete removal |
title_sort | case report of one of the largest {3.63 kg} renal tumour removed in the western hemisphere. a combined uro vascular approach for complete removal |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909724/ https://www.ncbi.nlm.nih.gov/pubmed/27284761 http://dx.doi.org/10.1016/j.ijscr.2016.05.036 |
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