PMC10063810_01
(A) Preoperative abdominal CT examination showing a 20 cm*16 cm RCC mass (the red arrow). (B) Abdominal CT scan after 1 week of the operation indicates a complete resection of the giant RCC mass. (C) The most recent abdominal CT scan indicates no sign of relapse. (D) The tendency chart presents the changes in the SCr level along with the progression of disease and treatment. CT, computed tomography; RCC, renal cell carcinoma; SCr, serum creatine.
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F1
In addition, CT imaging of the abdomen showed a right renal mass (211 mm x 159 mm) but revealed no hemorrhagic foci around the mass or thrombi in the renal vein (Figure 1A). A postoperative abdominal CT scan (August 25, 2020) indicated the total resection of the RCC mass (Figure 1B), and a pathological examination of the RCC mass showed that the renal sinus adipose tissue was involved locally, with no obvious breakthrough of fibrous capsule and no tumor involvement in the renal cutting edge or perirenal adipose tissue (pT3aM0N0, UISS III). NSS and was followed up every 3 months. Now, 26 months have passed since the operation, and the latest chest and abdominal CT scanning showed no sign of relapse or metastasis (June 3, 2022) (Figure 1C). In addition, the most recent follow-up revealed that the SCr level was 189.5 umol/L (Figure 1D), the BUN was 17.74 mmol/L, and the eGFR of the right kidney was 30.3 ml/min/1.73 m2 (22 August 2022).
(A) Pathological examination of renal biopsies: renal adenocarcinoma, ISUP grade IV; (B) Exposure of the surgical field and the clamping of the renal artery; (C) A considerable part of the RCC mass was shifted out of the body for the convenience of surgical operations; (D) weighing and measurement of the RCC mass. ISUP, International Society of Urological Pathology; RCC, renal cell carcinoma.
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F2
To study the characteristics of the giant mass, an ultrasound-guided renal biopsy was performed, and pathology reported RCC [renal adenocarcinoma, grade IV according to the International Society of Urological Pathology (ISUP) grading system, with transcription factor EB (TFEB) amplification] (31 July 2020) (Figure 2A). The resected mass weighed 5.8 kg (Figures 2B-D).
Timeline of the medical history, examination, and treatment.
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F3
The complete timeline is shown in Figure 3.