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Renal Tumour Abstract

The largest {3.63 kg. } renal tumour removed in the Western Hemisphere.
surgical, anesthetic and Pathological discourse for The Society of Surgeons of Trinidad & Tobago.
Lall R. Sawh, Steve Budhooram, Peng Ewe,Ryan Rattan, Sean L. Sawh

ABSTRACT

INTRODUCTION :

This paper describes the technique employed for the removal of the largest renal tumor in the Western Hemisphere and the second largest in the World. It is a road map for Surgeons in Training and should be of interest to other Surgeons/Urologists.

This tumor weighed 3.63 kg ; the world’s largest weighed 5.44 kg.

PRESENTATION OF CASE:

A 52 year old male presented with a one year history of progressive weight loss, a gradually enlarging abdomen and no other admissible symptom, including no haematuria. The mass started on his left side of the abdomen.

CT scans showed a large tumour arising from the left kidney.

DISCUSSION :

A combined Urological and vascular approach was chosen in view of the CT scans images of huge renal veins and collateral vessels. 

The left pleural cavity was elevated by the mass pushing on the left diaphragm and the heart was also displaced cranially as the mass made its own space.

Bowels were displaced as the giant mass reached into his pelvis.

A thoraco abdominal supra12 rib bed approach was adopted. The rib was not resected nor was the pleural cavity opened.

Histological diagnosis was renal  leiomyosarcoma.

CONCLUSION :

Large renal tumours or masses are best approached by the Urologist with an experienced vascular/general surgeon as assistant as well as a skilled anesthetist/Intensivist.

Optimisation, critical care and early mobilization of the patient by a dedicated nursing staff are essential to minimize complications and ensure a successful end result.

The success of this operation underscores what is possible in developing countries.

KEYWORDS:

Renal leiomyosarcoma

Western World’s largest renal tumour

Correspondence to :lallsawh@gmail.com