Background: Autosomal dominant polycystic kidney disease (ADPKD) is most common potentially lethal cystic disease occurring in ∼1 in 1000 live births. It is an important cause of end-stage renal disease, which occurs in 75% of patients by the age of 70 years. APDPKD is a systemic disease with involvement of multiple extrarenal organs. Incidence of renal cell cancer in ADPKD is no more than in normal population. High index of suspicion is required due to gross distortion of renal architecture. Case Presentation: We report a 56-year male, known case of ADPKD on maintenance hemodialysis presenting with hematuria. On evaluation, he was diagnosed with bilateral renal masses on contrast imaging. Bilateral laparoscopic nephrectomy was performed and specimen was retrieved from pfannenstiel incision. Histology showed papillary renal cancer in left kidney and oncocytoma in right kidney with negative margins. Conclusion: Minimally invasive surgery in ADPKD with renal mass is challenging due to space constraints and large size kidneys. However, laparoscopic approach is a feasible option with minimal morbidity, less pain, and speedy recovery, specially in chronic kidney disease patients already immunocompromised status. Copyright 2020, Mary Ann Liebert, Inc., publishers.
Background: Autosomal dominant polycystic kidney disease (ADPKD) is most common potentially lethal cystic disease occurring in ∼1 in 1000 live births. It is an important cause of end-stage renal disease, which occurs in 75% of patients by the age of 70 years. APDPKD is a systemic disease with involvement of multiple extrarenal organs. Incidence of renal cell cancer in ADPKD is no more than in normal population. High index of suspicion is required due to gross distortion of renal architecture. Case Presentation: We report a 56-year male, known case of ADPKD on maintenance hemodialysis presenting with hematuria. On evaluation, he was diagnosed with bilateral renal masses on contrast imaging. Bilateral laparoscopic nephrectomy was performed and specimen was retrieved from pfannenstiel incision. Histology showed papillary renal cancer in left kidney and oncocytoma in right kidney with negative margins. Conclusion: Minimally invasive surgery in ADPKD with renal mass is challenging due to space constraints and large size kidneys. However, laparoscopic approach is a feasible option with minimal morbidity, less pain, and speedy recovery, specially in chronic kidney disease patients already immunocompromised status. Copyright 2020, Mary Ann Liebert, Inc., publishers.
Entities:
Keywords:
ADPKD; laparoscopic; nephrectomy; renal cell cancer
Authors: Cordula A Jilg; Vanessa Drendel; Janina Bacher; Przemyslaw Pisarski; Hannes Neeff; Oliver Drognitz; Malte Schwardt; Sven Gläsker; Angelica Malinoc; Zoran Erlic; Mercedes Nunez; Alexander Weber; Pablo Azurmendi; Wolfgang Schultze-Seemann; Martin Werner; Hartmut P H Neumann Journal: Nephron Clin Pract Date: 2013-06-04