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Year : 2020  |  Volume : 3  |  Issue : 2  |  Page : 93-96

Renal cell carcinoma arising in an open pyelolithotomy scar: A perplexing scenario!

1 Department of Surgical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
2 Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India

Correspondence Address:
Dr. Ashutosh Mishra
Department of Surgical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi 110029.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jco.jco_26_20

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Renal cell carcinoma (RCC) arising in a renal tissue away from the normal kidney is quite rare with only a few cases reported in the literature. The management of such cases is challenging and requires an individualized treatment approach. We report a case of a young male with a prior history of pyelolithotomy who presented with a right paravertebral mass. CECT chest and abdomen revealed a soft-tissue mass near the right kidney with obvious infiltration into posterior abdominal wall muscles and 12th rib erosion. Image-guided biopsy of the mass demonstrated features of metastatic RCC. The patient underwent surgery with en bloc removal of the tumor with 12th rib, infiltrated paraspinal muscles, a small part of the densely adhered right kidney, and overlying skin. Histopathology with recommended IHC panels showed papillary RCC. Because of the above, the multidisciplinary tumor board considered this as a malignancy arising from a pyelolithotomy scar. The patient was planned for follow-up only without any adjuvant treatment. This case highlights the importance of a multidisciplinary team approach and comprehensive planning in such rare and perplexing cases.

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