Abstract
Transitional cell cancer (TCC) in the renal pelvis is usually treated by nephro-ureterectomy. In functional or anatomical singular renal units, consecutive chronic hemodialysis will be needed. We present a patient treated by image-guided robotic radiosurgery for definitive tumor control of a T2G3 recurrent transitional cell cancer of the renal pelvis in a singular renal unit after nephro-ureterectomy of the contralateral kidney.
Highlights
Transitional cell cancer (TCC) of the renal pelvis and ureters are relatively rare
Nephro-ureterectomy with excision of the bladder cuff is considered the standard therapy in patients with renal pelvis TCC, regionally extensive disease, and high-grade or high-stage lesions
Surgical removal leads to chronic hemodialysis with impaired quality of live and reduced overall survival
Summary
Transitional cell cancer (TCC) of the renal pelvis and ureters (upper urinary tract) are relatively rare. In an effort to avoid hemodialysis, we report on a patient with pT2 G3 TCC of the renal pelvis in a single remaining kidney singular renal unit after contralateral nephro-ureterectomy 30 years ago who was treated with single-session robotic radiosurgery. Small gold fiducials implanted in the proximity of the target are identified in both images and used to compute the 3D target position While this provides accurate information on the tumor location at the instant the X- rays are taken, this is not sufficient to obtain real-time motion information. The 75-year-old male patient underwent left-sided nephro-ureterectomy 30 years prior to radiosurgery treatment due to idiopathic hydronephrosis Four years ago, he developed recurrent TCC of the renal pelvis which was treated several times by ureterorenoscopic excisions and multiple laser coagulations.
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