Nephron-sparing surgery for clear cell carcinoma in a solitary functional kidney. Case report and literature review.

BACKGROUND

Since the introduction of nephron-sparing surgery, patients with small renal masses and diseases affecting overall renal function have greatly benefited.

CLINICAL CASE: We present the case of a 62-year-old male with a 6-cm left renal tumor in the medial parahilar segment with right renal unit functionally excluded, secondary to chronic obstruction due to ureteral lithiasis. Right ureteroscopy was performed with pneumatic lithotripsy. Despite localization and size of the tumor, left nephron-sparing surgery was performed in order to preserve renal function. Follow-up of the patient demonstrates no tumor activity.

CONCLUSIONS

Open nephron-sparing surgery has been the standard treatment for small renal masses with peripheral localization; however, in specific cases with deteriorated renal function and tumors >5 cm close to the renal hilum, certain risk must be taken in order to perform this procedure that has proven to be highly effective in preserving renal function. Open nephron-sparing surgery represents a highly effective procedure in small renal masses with a nonfunctional contralateral kidney.