Abstract
Berrak hücreli karsinom böbrek tümörlerinin en sık görülen histolojik alt tipidir ve 6. ve 8. dekadlar arasında daha çok görülmektedir. Bu yazımızda 70 yaşında sağ lomber bölgede ağrı ile kliniğimize başvuran ve biyopsi ile berrak hücreli karsinom saptayıp radyofrekans ablasyon tedavisi uyguladığımız hasta güncel literatür eşliğinde tartışılacaktır. Hipertansiyon, diyabeti ve konjestif kalp yetmezliği olan 70 yaşında bayan hasta sağ lomber bölgede 15 gündür süren ağrı nedeni ile kliniğimize başvurdu. Görüntüleme yöntemleri ile sağ böbrekte kitle tespit edildi. Hastaya ultrason eşliğinde perkütan tru-cut biopsi yapıldı. Histopatolojik olarak berrak hücreli karsinom olarak değerlendirildi. Komorbiditeleri nedeni ile cerrahi yapılamayan hastaya US eşliğinde perkütan yolla radyofrekans ablasyon uygulandı. Hastanın takibinde çekilen batın tomografilerinde lezyona uyan bölgede skar dokusu izlendi ve yeni bir lezyon tespit edilmedi. Hastanın takibi devam etmektedir. Berrak hücreli karsinom sıklığı giderek artmakta ve insidental olarak yapılan görüntülemeler sayesinde hastalar asemptomatik ve böbreğe sınırlı evrede karşımıza çıkmaktadır. Cerrahi açıdan uygun olmayan soliter böbreği ve böbrek kanseri olan hastalarda cerrahiye alternatif olarak radyofrekans ablasyon ve kriyoablasyon tedavileri düşünülmelidir
Keywords
References
- 1. Störkel S, Van den Beg E. Morphological classification of renal canser.World J Urol 1995;13:153-8.
- 2. European Network of Canser Registries. Eurocim Version 4. Europen İndices Databes V3.730 entitiy dictinary (2001), Lyon, 2001.
- 3. Beck SD, Patel MI, Snyder ME, et al. Effect of papillary and chromophobe cell type on disease-free survival after nephrectomy for renal cell carsinoma. Ann Surg Oncol 2004;11:71-7.
- 4. Park S, Cadeddu JA. Outcomes of radiofrequency ablation for kidney cancer. Cancer Control 2007;14:205-10.
- 5. Matin SF, Gill IS, Worley S, Novick AC. Outcome of laparoscopic radical and open partial nephrectomy for the sporadic 4 cm. or less renal tumor with a normal contralateral kidney. J Urol 2002;168:1356-9.
- 6. Lamb GW, Bromwich EJ, Vasey P, Aitchison M. Management of renal masses in patients medically unsuitable for nephrectomy-natural history, complications and outcome. Urology 2004;64:909
- 7. Ure I, Sözen S. Böbrek tümörlerinde laparoskopik radyofrekans ablasyon ve kriyoablasyon. Uroonkoloji Bülteni 2007;3:16-20.
Abstract
Clear cell carcinoma is the most common histological subtype of malignant kidney tumors and the incidence is higher in the 6th to 8th decades of life. We discuss here against the background of current literature a seventyyear-old patient who presented to our clinic with pain in the right lumbar region. A diagnosis of clear cell carcinoma was obtained by biopsy and the patient was given radiofrequency ablation treatment. The 70-year old female patient, who had hypertension, diabetes and congestive heart deficiency, came to our clinic with a complaint of pain in the right lumbar region for the last 15 days. By imaging methods, a mass in the right kidney was detected. An ultrasound-guided percutaneous trucut biopsy was performed. The case was evaluated histopathologically as clear cell carcinoma. Because surgery was contraindivated due to her comorbidities, the patient was given ultrasound-guided percutaneous radiofrequency ablation. In the abdominal tomographies performed during the follow-up scar tissue was seen in the region associated with the lesion and no new lesion was detected. The follow-up is continuing. Clear cell carcinoma incidence appears to be on the increase, and thanks to incidental imaging discoveries the condition is caught in an asymptomatic and kidney-limited stage. Radiofrequency ablation or cryoablation must be considered an alternative in patients with a solitary kidney or with renal carcinoma should there be a contraindication for surgery.
Keywords
References
- 1. Störkel S, Van den Beg E. Morphological classification of renal canser.World J Urol 1995;13:153-8.
- 2. European Network of Canser Registries. Eurocim Version 4. Europen İndices Databes V3.730 entitiy dictinary (2001), Lyon, 2001.
- 3. Beck SD, Patel MI, Snyder ME, et al. Effect of papillary and chromophobe cell type on disease-free survival after nephrectomy for renal cell carsinoma. Ann Surg Oncol 2004;11:71-7.
- 4. Park S, Cadeddu JA. Outcomes of radiofrequency ablation for kidney cancer. Cancer Control 2007;14:205-10.
- 5. Matin SF, Gill IS, Worley S, Novick AC. Outcome of laparoscopic radical and open partial nephrectomy for the sporadic 4 cm. or less renal tumor with a normal contralateral kidney. J Urol 2002;168:1356-9.
- 6. Lamb GW, Bromwich EJ, Vasey P, Aitchison M. Management of renal masses in patients medically unsuitable for nephrectomy-natural history, complications and outcome. Urology 2004;64:909
- 7. Ure I, Sözen S. Böbrek tümörlerinde laparoskopik radyofrekans ablasyon ve kriyoablasyon. Uroonkoloji Bülteni 2007;3:16-20.
Details
| Other ID | JA62FF96TV |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | August 1, 2013 |
| Published in Issue | Year 2013 Volume: 14 Issue: 2 |