"Extreme" renal preservation: Neoadjuvant chemotherapy and percutaneous resection for upper-tract urothelial carcinoma in a patient with solitary kidney - A case report

Steve K. Williams, Christopher Atalla, Reza Ghavamian, Cy Stein, David M. Hoenig

Research output: Contribution to journalArticle

Abstract

Background and Purpose: Renal preservation in selected patients with upper-tract urothelial cancer (UTUC) has been well described, offering an alternative to radical nephroureterectomy. We present our experiences in performing percutaneous treatments after neoadjuvant chemotherapy in one such patient with a large, complex, high-grade UTUC in a solitary kidney. Case Report: A 55-year-old woman with a solitary kidney presented with a 5.2 cm enhancing mass with calcifications involving the left renal pelvis and lower pole. Cystoscopy and retrograde pyelography demonstrated normal bladder mucosa. Ureteroscopy revealed a large, papillary tumor occupying the renal pelvis. Ureteroscopic treatment was deemed impossible because of the lesion's volume. We proceeded with percutaneous resection after downsizing the tumor after a course of neoadjuvant chemotherapy. Using a 25F resectoscope via a percutaneous tract, resection was performed to fully excise the tumor, and the patient received two postoperative chemotherapy courses. A recurrence developed within an isolated calix 8 months postoperatively, which was also managed percutaneously. Conclusion: A multimodal approach in a highly motivated patient could represent a reasonable strategy for patients in whom such a therapy is desired.

Original languageEnglish (US)
Pages (from-to)427-431
Number of pages5
JournalJournal of Endourology
Volume27
Issue number4
DOIs
StatePublished - Apr 1 2013

Fingerprint

Carcinoma
Kidney
Drug Therapy
Kidney Pelvis
Neoplasms
Ureteroscopy
Cystoscopy
Neoadjuvant Therapy
Urography
Mucous Membrane
Urinary Bladder
Recurrence
Therapeutics

ASJC Scopus subject areas

  • Urology

Cite this

"Extreme" renal preservation : Neoadjuvant chemotherapy and percutaneous resection for upper-tract urothelial carcinoma in a patient with solitary kidney - A case report. / Williams, Steve K.; Atalla, Christopher; Ghavamian, Reza; Stein, Cy; Hoenig, David M.

In: Journal of Endourology, Vol. 27, No. 4, 01.04.2013, p. 427-431.

Research output: Contribution to journalArticle

Williams, Steve K. ; Atalla, Christopher ; Ghavamian, Reza ; Stein, Cy ; Hoenig, David M. / "Extreme" renal preservation : Neoadjuvant chemotherapy and percutaneous resection for upper-tract urothelial carcinoma in a patient with solitary kidney - A case report. In: Journal of Endourology. 2013 ; Vol. 27, No. 4. pp. 427-431.
@article{f1a792c6680843e9a50eeee270d49df9,
title = "{"}Extreme{"} renal preservation: Neoadjuvant chemotherapy and percutaneous resection for upper-tract urothelial carcinoma in a patient with solitary kidney - A case report",
abstract = "Background and Purpose: Renal preservation in selected patients with upper-tract urothelial cancer (UTUC) has been well described, offering an alternative to radical nephroureterectomy. We present our experiences in performing percutaneous treatments after neoadjuvant chemotherapy in one such patient with a large, complex, high-grade UTUC in a solitary kidney. Case Report: A 55-year-old woman with a solitary kidney presented with a 5.2 cm enhancing mass with calcifications involving the left renal pelvis and lower pole. Cystoscopy and retrograde pyelography demonstrated normal bladder mucosa. Ureteroscopy revealed a large, papillary tumor occupying the renal pelvis. Ureteroscopic treatment was deemed impossible because of the lesion's volume. We proceeded with percutaneous resection after downsizing the tumor after a course of neoadjuvant chemotherapy. Using a 25F resectoscope via a percutaneous tract, resection was performed to fully excise the tumor, and the patient received two postoperative chemotherapy courses. A recurrence developed within an isolated calix 8 months postoperatively, which was also managed percutaneously. Conclusion: A multimodal approach in a highly motivated patient could represent a reasonable strategy for patients in whom such a therapy is desired.",
author = "Williams, {Steve K.} and Christopher Atalla and Reza Ghavamian and Cy Stein and Hoenig, {David M.}",
year = "2013",
month = "4",
day = "1",
doi = "10.1089/end.2012.0521",
language = "English (US)",
volume = "27",
pages = "427--431",
journal = "Journal of Endourology",
issn = "0892-7790",
publisher = "Mary Ann Liebert Inc.",
number = "4",

}

TY - JOUR

T1 - "Extreme" renal preservation

T2 - Neoadjuvant chemotherapy and percutaneous resection for upper-tract urothelial carcinoma in a patient with solitary kidney - A case report

AU - Williams, Steve K.

AU - Atalla, Christopher

AU - Ghavamian, Reza

AU - Stein, Cy

AU - Hoenig, David M.

PY - 2013/4/1

Y1 - 2013/4/1

N2 - Background and Purpose: Renal preservation in selected patients with upper-tract urothelial cancer (UTUC) has been well described, offering an alternative to radical nephroureterectomy. We present our experiences in performing percutaneous treatments after neoadjuvant chemotherapy in one such patient with a large, complex, high-grade UTUC in a solitary kidney. Case Report: A 55-year-old woman with a solitary kidney presented with a 5.2 cm enhancing mass with calcifications involving the left renal pelvis and lower pole. Cystoscopy and retrograde pyelography demonstrated normal bladder mucosa. Ureteroscopy revealed a large, papillary tumor occupying the renal pelvis. Ureteroscopic treatment was deemed impossible because of the lesion's volume. We proceeded with percutaneous resection after downsizing the tumor after a course of neoadjuvant chemotherapy. Using a 25F resectoscope via a percutaneous tract, resection was performed to fully excise the tumor, and the patient received two postoperative chemotherapy courses. A recurrence developed within an isolated calix 8 months postoperatively, which was also managed percutaneously. Conclusion: A multimodal approach in a highly motivated patient could represent a reasonable strategy for patients in whom such a therapy is desired.

AB - Background and Purpose: Renal preservation in selected patients with upper-tract urothelial cancer (UTUC) has been well described, offering an alternative to radical nephroureterectomy. We present our experiences in performing percutaneous treatments after neoadjuvant chemotherapy in one such patient with a large, complex, high-grade UTUC in a solitary kidney. Case Report: A 55-year-old woman with a solitary kidney presented with a 5.2 cm enhancing mass with calcifications involving the left renal pelvis and lower pole. Cystoscopy and retrograde pyelography demonstrated normal bladder mucosa. Ureteroscopy revealed a large, papillary tumor occupying the renal pelvis. Ureteroscopic treatment was deemed impossible because of the lesion's volume. We proceeded with percutaneous resection after downsizing the tumor after a course of neoadjuvant chemotherapy. Using a 25F resectoscope via a percutaneous tract, resection was performed to fully excise the tumor, and the patient received two postoperative chemotherapy courses. A recurrence developed within an isolated calix 8 months postoperatively, which was also managed percutaneously. Conclusion: A multimodal approach in a highly motivated patient could represent a reasonable strategy for patients in whom such a therapy is desired.

UR - http://www.scopus.com/inward/record.url?scp=84876159391&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876159391&partnerID=8YFLogxK

U2 - 10.1089/end.2012.0521

DO - 10.1089/end.2012.0521

M3 - Article

C2 - 23442142

AN - SCOPUS:84876159391

VL - 27

SP - 427

EP - 431

JO - Journal of Endourology

JF - Journal of Endourology

SN - 0892-7790

IS - 4

ER -