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Case Series of Bedside Renal Cell Carcinoma Detected by Point-of-Care Ultrasound in the Ambulatory Setting

Background: Kidney and renal pelvic cancer was the sixth most common cancer in men and 10th most common in women in the United States in 2018. Renal cell carcinoma (RCC), accounts for 86% of malignancies of the kidney. RCC patients are often asymptomatic; up to 25-30% have metastases at diagnosis. F...

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Autores principales: Setia, Gayatri, Kedan, Ilan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232876/
https://www.ncbi.nlm.nih.gov/pubmed/32340587
http://dx.doi.org/10.1177/2150132720916279
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author Setia, Gayatri
Kedan, Ilan
author_facet Setia, Gayatri
Kedan, Ilan
author_sort Setia, Gayatri
collection PubMed
description Background: Kidney and renal pelvic cancer was the sixth most common cancer in men and 10th most common in women in the United States in 2018. Renal cell carcinoma (RCC), accounts for 86% of malignancies of the kidney. RCC patients are often asymptomatic; up to 25-30% have metastases at diagnosis. Few present with the triad of gross hematuria, flank pain, and abdominal mass. In RCC patients, 36% had 2 symptoms of the triad, and 60% had gross hematuria as 1 symptom. Point-of-care ultrasound (POCUS) offers a way to identify clinically meaningful anatomic abnormalities. This case series presents 3 patients in whom routine POCUS examination performed in an outpatient cardiology clinic found asymptomatic renal masses, resulting in surgical resection and cure of early-stage RCCs. Case Presentation: Patient 1: 54-year-old female with hypertension (HTN). Two solid masses were identified with POCUS in the right kidney. Patient 2: 63-year-old male with coronary artery disease (CAD) and HTN was seen at an 8-month follow-up visit. A 6-cm mass was identified in the left kidney. Patient 3: 69-year-old male with CAD, HTN, and smoking history seen at 5-month follow-up visit. A 3-cm mass in the right kidney was identified. Conclusions: Incorporating POCUS into the routine physical examination in the ambulatory care setting may improve rates of detection and increase the pretest probability of identifying renal pathology with formal imaging studies. With minimal clinician training, earlier and increased detection of asymptomatic RCC may result in improved patient survival.
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spelling pubmed-72328762020-05-29 Case Series of Bedside Renal Cell Carcinoma Detected by Point-of-Care Ultrasound in the Ambulatory Setting Setia, Gayatri Kedan, Ilan J Prim Care Community Health Case Studies Background: Kidney and renal pelvic cancer was the sixth most common cancer in men and 10th most common in women in the United States in 2018. Renal cell carcinoma (RCC), accounts for 86% of malignancies of the kidney. RCC patients are often asymptomatic; up to 25-30% have metastases at diagnosis. Few present with the triad of gross hematuria, flank pain, and abdominal mass. In RCC patients, 36% had 2 symptoms of the triad, and 60% had gross hematuria as 1 symptom. Point-of-care ultrasound (POCUS) offers a way to identify clinically meaningful anatomic abnormalities. This case series presents 3 patients in whom routine POCUS examination performed in an outpatient cardiology clinic found asymptomatic renal masses, resulting in surgical resection and cure of early-stage RCCs. Case Presentation: Patient 1: 54-year-old female with hypertension (HTN). Two solid masses were identified with POCUS in the right kidney. Patient 2: 63-year-old male with coronary artery disease (CAD) and HTN was seen at an 8-month follow-up visit. A 6-cm mass was identified in the left kidney. Patient 3: 69-year-old male with CAD, HTN, and smoking history seen at 5-month follow-up visit. A 3-cm mass in the right kidney was identified. Conclusions: Incorporating POCUS into the routine physical examination in the ambulatory care setting may improve rates of detection and increase the pretest probability of identifying renal pathology with formal imaging studies. With minimal clinician training, earlier and increased detection of asymptomatic RCC may result in improved patient survival. SAGE Publications 2020-04-27 /pmc/articles/PMC7232876/ /pubmed/32340587 http://dx.doi.org/10.1177/2150132720916279 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Studies
Setia, Gayatri
Kedan, Ilan
Case Series of Bedside Renal Cell Carcinoma Detected by Point-of-Care Ultrasound in the Ambulatory Setting
title Case Series of Bedside Renal Cell Carcinoma Detected by Point-of-Care Ultrasound in the Ambulatory Setting
title_full Case Series of Bedside Renal Cell Carcinoma Detected by Point-of-Care Ultrasound in the Ambulatory Setting
title_fullStr Case Series of Bedside Renal Cell Carcinoma Detected by Point-of-Care Ultrasound in the Ambulatory Setting
title_full_unstemmed Case Series of Bedside Renal Cell Carcinoma Detected by Point-of-Care Ultrasound in the Ambulatory Setting
title_short Case Series of Bedside Renal Cell Carcinoma Detected by Point-of-Care Ultrasound in the Ambulatory Setting
title_sort case series of bedside renal cell carcinoma detected by point-of-care ultrasound in the ambulatory setting
topic Case Studies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232876/
https://www.ncbi.nlm.nih.gov/pubmed/32340587
http://dx.doi.org/10.1177/2150132720916279
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