TUBERCULOSIS, CALCULI AND ADENOCARCINOMA OF THE SAME KIDNEY TREATED BY PARTIAL NEPHRECTOMY

Abstract

A case of tuberculosis, with calculi and adenocarcinoma in the same kidney and treated by partial nephrectomy, was reported. The case was a 69-year-old man who visited our clinic with the chief complaint of gross hematuria. Urographic examination revealed small renal calculi and a moth-eaten appearance of the left lower calyx which was compatible with tuberculosis. The left selective renal arteriogram showed the angiographic pattern of chronic pyelonephritis without neovascularity.
Left partial nephrectomy on lower third was performed. Postoperative course was uneventful but histologic examination of the specimen revealed tuberculous changes and small adenocarcinoma. The tumor showed tubular and papillary proliferation of atypical clear cells with no tumor in the margin.
Left secondary nephrectomy was not performed and chemotherapy for tuberculosis was continued for one year. The patient is alive and well with no evidence of recurrent tumor two years later.
In discussion, we reviewed the problems of associated renal tuberculosis and malignancy, avascular renal tumor and conservative surgery in certain renal tumors.