Shahid Mehmood Rana, Rafiq Zafar, Muhammad Rehan Burney.
Renal Cell Carcinoma in a horseshoe Kidney.
Pak Armed Forces Med J Nov ;52(2):219-20.

A 53 years old male presented to us with complaints of haematuria and left loin pain for the last one year. The haematuria was intermittent, usually gross and at times resulted in clot retention. The left loin pain was dull in character, non-radiating, mild in severity having no relation with posture or food. There was no history of fever, cough or significant weight loss. On examination patient was pale looking and there was a nontender, bimanually palpable firm mass in left hypochondrium and lumber region measuring about 15 x 20 cm. Patient was anaemic and radiological investigations revealed horseshoe kidney with an irregular, mixed density mass on left side. The mass showed non-homogeneous contrast enhancement. Using transverse incision and transperitoneal approach, radical left heminephrectomy with division of the isthmus was performed. Biopsy report revealed clear call carcinoma (grade - III). There was no evidence of invasion of perinephric fat, ureter or renal vein. The tumor was staged as T2 NO MO in TNM staging system and Stage-1 in Robson staging system.

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