UofT GU Oncology, 2004 CLINICAL CASES. UofT GU Oncology, 2004 73 y.o. female Familiar history:...

UofT GU Oncology, 2004

CLINICAL CASES


73 y.o. female

Familiar history: Thyroid cancer (mother)Prostate cancer (father)

PMH: hypertension, diabetes mellitus, histerectomy

CLINICAL CASE 1


Abdominal US:incidental

finding of a left small renal mass

CLINICAL CASE 1


Abdominal CT

Left 2.5 cm renal mass

CLINICAL CASE 1


Would you propose other diagnostic tests ?

Abdominal MRI ?

PET-CT ?

Chest x-ray/CT scan ?

Percutaneous biopsy ?

CLINICAL CASE 1


Percutaneous biopsy

Path: oncocytoma

CLINICAL CASE 1


What would you do?

Partial nephrectomy ?

RFA/cryoablation ?

Follow-up with annual abdominal US ?

No follow-up ?

CLINICAL CASE 1


What did we do?

Follow-up with annual abdominal US

The renal mass is stable in size at 24 mos

follow-up

CLINICAL CASE 1


55 y.o. male

Smoker

Asymptomatic

Incidental finding of a renal mass at US for check-up

Clinical examination: unremarkable

FBC, Biochemistry, U/A: normal

CLINICAL CASE 2


Would you propose other diagnostic tests ?

Abdominal MRI ?

PET-CT ?

Chest x-ray/CT scan ?

Percutaneous biopsy ?

CLINICAL CASE 2


What would you do?

Radical nephrectomy? Partial nephrectomy ?

Open

Laparoscopic

Robot-assisted

RFA/cryoablation ? Active surveillance ?

CLINICAL CASE 2


What did we do?

Robot-assisted partial nephrectomy

Path: pT1a clear cell RCC Fuhrman III

CLINICAL CASE 2


53 y.o. male Non smoker Flank pain and hematuria Clinical examination: unremarkable FBC: mild anaemia (Hb=10.2 g/dL) BUN = 49 mg/dL Creatinine = 1.7 mg/dL (150.28 μmol/L) U/A: Microscopic hematuria

CLINICAL CASE 3


What would you do?

Bilateral partial nephrectomy (PN) ? Bilateral radical nephrectomy (RN) ? Right RN and concomitant left PN ? Right RN and staged left PN ? Left PN and staged right RN ? Right RN and left RFA/cryoblation ? Right RN and active surveillance of left tumor?

CLINICAL CASE 3


What did we do?

Left PN and staged right RN

Path: bilateral clear cell RCC, Fuhrman III right,

Fuhrman II left

CLINICAL CASE 3

UofT GU Oncology, 2004 CLINICAL CASES. UofT GU Oncology, 2004 73 y.o. female Familiar history:...

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