RCC

Case # 1
• A 56 years old male , known diabetic, had an usg abdomen for lower
abdomen pain and incidentally found a mass in left kidney lower pole
measuring 3.8 cm in its greatest dimension. His history & examination
is unremarkable. CECT Chest abdomen and pelvis showed a contrast
enhanced mass of same size arising from lower pole of left kidney
with its exophytic component. In venous phase of CT there was
washout of contrast from the mass. No Lymphadenopathy or
evidence of metastatic disease.His routine baseline labs are within
normal limits. His ECOG is 0 and ASA 2.
• What will you do?
• PN/NSS vs RN

• Indications of PN/NSS

• Assessment of tumor complexity

Case # 2
• A 67 y male presented in ER with pain in right flank from past 2
weeks. He has no comorbids and h/o cigarette smoking of 30 pack
years. O/E he looks pale and right kidney is palpable along with a
mass in right flank. After getting his routine baseline labs, CECT chest
abdomen and pelvis was ordered, which showed a contrast enhanced
mass about 10.6x8.3 cm in size arising from the midpole of right
kidney. Mass contains areas of necrosis in it. Right renal vein showed
a thrombus in it extending in IVC superiorly involving the intrahepatic
portion of the IVC but below the diaphragm. There are few enlarged
para-aortic lymph nodes. No evidence of metastatic disease in chest.
• TNM

• What are stages of the level of IVC thrombus

• Vascular control for IVC thrombectomy

Case # 3
• A 60 years old male presented in OPD with h/o persistent cough ,
malaise and weight loss from past 3 months. O/E there are 2 palpable
cervical lymph nodes. After routine baseline labs, CECT chest
abdomen and pelvis done which showed 1 nodule in the superior
lobe of left lung. Right kidney showed a contrast enhanced lesion
measuring about 6x8.3 cm. Renal vein is spared. No significant
enlarged lymph node around aorta.
• What are options of management

• Cytoreductive nephrectomy

• CARMENA study