Staghorn Renal-Cell Carcinoma

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     A 72-year-old woman with a history of hematuria presented with a three-month history of weight loss and anorexia. Computed tomography (Panel A) and ultrasonography showed a solid mass infiltrating the renal pelvis of the nonfunctioning right kidney. The serum creatinine concentration was 1.1 mg per deciliter (97.2 μmol per liter), and cytologic examination of the urine revealed no abnormalities. Subsequent radical nephrectomy confirmed the presence of the mass at the upper pole and also revealed a complete staghorn pyelocaliceal and ureteral mass (Panel B). Histologic analysis showed that the lesion was a poorly differentiated renal-cell carcinoma (stage pT3aN0M0 according to the tumor–node–metastasis classification system). Lung metastases developed three years after surgery. The patient was treated with systemic administration of interferon but died of progressive disease 18 months later.

    Lorenzo G. Luciani, M.D.

    Lucio Luciani, M.D.

    S. Chiara Hospital

    38100 Trento, Italy

    http://www.100md.com/html/DirDu/2006/11/29/30/64/56.htm