Síndrome diarreico y carcinoma de células renales

Abstract

A 36-year-old male with diarrhea and loss of weight underwent testing for blood chemistry, TSH, immunological parameters, celiac profile, and parasites in feces. All results were normal. C-reactive protein was elevated. Colonoscopy up to the cecum was normal, and a small-bowel follow-through with barium showed no alterations. Abdominal echography showed a left renal upper-pole mass about 4 cm in diameter, round, and isoechoic with hyperechoic areas inside consistent with necrotic areas (Fig. 1). CTA confirmed this lesion as 4.3 cm in size, hypodense, confined to the kidney and not affecting the perirenal fat or vascular pedicle. The patient was sent to the Urology Department and underwent a left laparoscopic nephrectomy -a mass could be macroscopically seen in a pole, with a complete Gerota’s capsule and no significant macroscopic changes. Cuts allowed identifying a rounded, well delimited lesion 4.8 x 4.5 cm in size in that pole, with a yellowish-brownish parenchyma with small millimetric cavities that was friable at the cut close to the renal capsule. The diagnosis was of papillary renal cell carcinoma, type 2 according to Delahunt and Eble (Fig. 2). The patient is now asymptomatic, and diarrhea is no longer present after surgery.