Cases reported "Carcinoma, Renal Cell"

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1/273. Unusual cause of intraoperative hypotension diagnosed with transoesophageal echocardiography in a patient with renal cell carcinoma.

    Transoesophageal echocardiography (TOE) is not commonly used in the management of non-cardiac cases. We report a case where the use of TOE played a major role in the intraoperative diagnosis and subsequent management of a patient exhibiting severe hypotension whilst undergoing a nephrectomy. The rare diagnosis of a secondary intraventricular tumour would not have been evident with more conventional monitoring techniques.
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2/273. Surgical treatment for metastatic lung tumors with incidentally coexisting lung cancer.

    We report four surgically resected cases of a metastatic lung tumors with incidentally coexisting lung cancer. Two patients (Cases 1 and 2) were admitted for surgical treatment for pulmonary metastases from colon cancer, and the other two (Cases 3 and 4) were for pulmonary metastases from renal cell carcinoma. In only one patient (Case 3), one lesion among the multiple shadows on the preoperative computed tomography examination was rather strongly suspected to be primary lung cancer. In three patients (Cases 1, 2 and 3), one of the resected lesions in each individual case was diagnosed as lung adenocarcinoma by an intraoperative examination using frozen sections, and was later histologically confirmed. In Case 4, one of the resected lesions was postoperatively determined to be lung adenocarcinoma. All coexisting lung cancers, treated with partial resection of the lung, were well-differentiated small-sized adenocarcinoma (T1N0), while the other lesions resected in each case were metastases from the individual cancer. Problems in preoperative diagnosis and surgical treatment for metastatic lung tumors with incidentally coexisting lung cancer are discussed.
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3/273. Extra-adrenal phechromocytoma and renal cell carcinoma--an unusual case of tumour synchronism.

    We report an unusual case of tumour synchronism combining an extra-adrenal pheochromocytoma and a renal cell carcinoma in a 48-year-old male. The most usual forms of presentation are described in accordance with their clinical significance. We emphasize the diagnostic importance of specific biochemical studies and the accurate anatomical localization of extra-adrenal chromaffin tissue by magnetic resonance imaging (MRI) and scintigraphy with 131 iodine-methyliodobenzylguanidine (131I-MIBG). Surgical excision was the treatment of choice after the institution of adequate preoperative cardiovascular management. Pertinent features of the natural history of these tumours are described in accordance with their different embryological origin.
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4/273. Simultaneous contralateral testicular metastasis from a renal clear cell carcinoma.

    The case of a 66-year-old male with a right renal cell carcinoma and a left testicular mass is reported. Radical nephrectomy and contralateral orchidectomy were performed. histology revealed a metastasis of the renal cell carcinoma of clear cell type into the left testis. The patient died seven months post-operatively of disseminated lung metastases. The case demonstrates the multi-ocular metastatic potential of renal cell carcinoma.
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5/273. Perioperative brachytherapy as an additional therapeutic option in patients with renal cell carcinoma (RCC), either inoperable or after completed percutaneous radiotherapy.

    Between January 1992 and December 1997 60 patients with different tumors were treated with perioperative high dose rate brachytherapy with iridium 192 in afterloading technique (HDR), total dosis 20-30 Gy. Three of the patients had RCC. These patients are presented in detail. In elected patients in whom other forms of treatment are not available or have failed, the method offers an additional therapeutic option and can achieve excellent results.
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6/273. Metastatic spine disease in renal cell carcinoma--indication and results of surgery.

    Metastatic spine disease is frequent in renal cell carcinoma and 50% of osseous metastases are already found at the time of primary diagnosis. Therefore patient mobility and quality of life are threatened early in the course of disease. Surgery is able to relieve pain and to regain or to preserve mobility. Indication and technique of surgery (anterior decompression, vertebral replacement and transpedicular fixation) are explained and treatment results of eleven cases are reported. All patients with paraparesis or cord compression preoperatively were mobile when leaving our hospital after surgery. There were no severe complications, especially no neurological deteriorations or deaths. Postoperative survival time was ten months approximately in cases with multiple osseous lesions and it was several years in cases with solitary metastases. Mobility was preserved for most of the survival time. In conclusion, restabilisation of the spine proved to be a worthwhile treatment option in well-selected cases suffering from malignant spinal involvement.
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7/273. Renal cell carcinoma presenting as a pseudo-carcinoid tumour.

    A 38-year-old woman presented with hypertension and a renal cell carcinoma. Raised urinary 5-hydroxyindoleacetic acid values >300 micromol/l, predictive of carcinoid tumour, were found during the perioperative period. The values returned towards normal 2 weeks post-surgery. Immunohistochemical examination of the renal cell carcinoma with neuroendocrine markers was negative. Despite a diligent search, no carcinoid tumour could be identified and the patient was well 4 years later. There was no dietary or drug explanation for this pseudocarcinoid.
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8/273. Fat detection in granular-cell renal cell carcinoma using chemical-shift gradient-echo MR imaging: another renal tumor that contains fat.

    Preoperative chemical-shift magnetic resonance images in a 56-year-old man suggested the presence of microscopic fat in the tumor. The surgical specimen showed a granular-cell renal cell carcinoma with papillary architecture, associated with abundant fat-containing foamy histiocytes in the interstitium. The radiologist should include this entity in the differential diagnoses of renal tumors that contain microscopic fat.
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9/273. Solitary metachronous splenic metastases: an evaluation of surgical treatment.

    Splenic metastases occurring after primary tumor removal and apparently solitary have been documented only recently in literature. They are, most of the times, clinically asymptomatic and their presence is casually determined by ultrasonographic follow-up in subjects otherwise in good conditions. The belief that splenic metastases occur only in disseminated cancer is today no longer accepted. Some Authors consider solitary splenic metachronous metastases eligible for surgical treatment as well as pulmonary or hepatic metastases. In the case presented, surgery was required due to abscess formation of a splenic metastasis, which was not responding to chemotherapy. Our experience, like others reported in literature, verified a long-term post-operative survival in spite of limited disease-free time. Surgical treatment by splenectomy can be indicated in selected patients, considering that chemotherapy has been proved to be ineffective in the treatment of splenic metastases.
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10/273. Renal cell carcinoma in cases of adult polycystic kidney disease: changing diagnostic and therapeutic implications.

    Renal cell carcinoma in adult polycystic kidney disease is of rare occurrence and poses a diagnostic and therapeutic challenge. We have treated three such patients in our department. One was male and two were females ranging in age from 20 to 60 years. All were diagnosed preoperatively with ultrasonography or contrast-enhanced CT. Radical nephrectomy was performed in all patients. During the follow-up no patient had recurrence in the contralateral kidney. One patient had local recurrence in the renal fossa and was treated with local radiotherapy and immunotherapy. In the past due to difficulty in diagnosis, invasive investigations like angiography were recommended and prophylactic contralateral nephrectomy was often undertaken. With the availability of reliable noninvasive investigations these patients can be diagnosed accurately and the contralateral kidney saved in most cases.
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ranking = 0.2
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