Nephron-sparing radical excision of a giant perirenal liposarcoma involving a solitary kidney

Gaston, K. E.; White Jr., R. L; Homsi, S.; Teigland, C.; White, R L Jr
April 2007
American Surgeon;Apr2007, Vol. 73 Issue 4, p377
Academic Journal
journal article
We describe our experience in a patient with a congenital solitary kidney encased by a perirenal liposarcoma managed by nephron-sparing excision. The best predictor of survival with liposarcoma is complete resection of the tumor. Generally a diffuse peri-renal liposarcoma arising within Gerota's fascia would necessitate a radical nephrectomy. Having a congenitally solitary kidney, this patient refused nephrectomy, therefore a kidney-sparing excision of his liposarcoma was attempted. To obtain negative margins and to provide a nephron-sparing excision, the capsule of the kidney was resected with the mass. Direct extension into the diaphragm necessitated an en bloc resection of 4 x 6 cm of the left hemidiaphragm. The defect was reconstructed with a Gortex patch graft. Pathology revealed a 32 x 22 x 8-cm liposarcoma with areas of sclerosing liposarcoma and poorly differentiated spindle cell sarcoma, focally Grade 3 of 3, with the remaining tumor being Grade 1. There was diaphragmatic invasion, but all surgical margins were negative. At 22 months CT follow-up, the patient has no radiographic evidence of disease. Excision of this mass with the renal capsule allowed our patient to be margin negative and maintain normal renal function. This is the only report in the literature describing nephron-sparing resection of a giant perirenal liposarcoma involving a solitary kidney.


Related Articles

  • Partial nephrectomy for localized RCC long term follow up. Prabha, Vikram; Nerli, R. B.; Reddy, Mallikarjun // Indian Journal of Urology;Supplement1, Vol. 24, pS7 

    Introduction: Interest in nephron sparing surgery for RCC has been stimulated by advances in renal imaging, improved methods of preventing ischemic renal damage, growing numbers of incidentally discovered low stage RCC's, and good long term survival in patients undergoing this form of treatment....

  • Nephron sparing surgery: A single institution experience. Agrawal, S.; Jha, M. S.; Khurana, N.; Ansari, M. S. A.; Dubey, D.; Srivastava, A.; Kapoor, R.; Kumar, A.; Jain, M.; Mandhani, A. // Indian Journal of Urology;Jan-Mar2007, Vol. 23 Issue 1, p23 

    Objective: To report our experience in managing various benign and malignant renal tumors with nephron-sparing surgery. Materials and Methods: Records of patients who underwent nephron-sparing surgery (NSS) either through open or laparoscopic approach between May 1997 and June 2006 at our...

  • Optimization of Image-Guided Targeting in Renal Focal Therapy. Leveillee, Raymond J.; Ramanathan, Rajan // Journal of Endourology;May2010, Vol. 24 Issue 5, p729 

    AbstractFocal renal therapy for small renal masses (T1aor T1b) has been used as primary treatment for patients with comorbidities who are considered poor candidates for surgical resection. With a continuing effort toward optimization of minimally invasive nephron-sparing modalities, the effort...

  • Optimized haemostasis in nephron-sparing surgery using small-intestine submucosa. Simon, Jörg; de Petriconi, Robert; Meilinger, Michael; Hautmann, Richard E.; Bartsch Jr., Georg // BMC Urology;2008, Vol. 8, Special section p1 

    Background: The indications for nephron-sparing surgery are expanding constantly. One major contributing fact for this development is the improvement of haemostatic techniques following excision of the tumor. Nevertheless, postoperative bleeding complications still occur. To prevent this, we...

  • Internephron heterogeneity of growth factors and sclerosis. Fogo, Agnes // Kidney International Supplement;Feb1994, Issue 45, pS-24 

    Discusses the internephron heterogeneity of growth factors and sclerosis. Increase in glomerular capillary pressure and hyperfiltration in rats with ureteral diversion and partial nephrectomy of the contralateral kidney; Correlation between early glomerulosclerosis and glomerular staining for...

  • Nephron sparing surgical intervention as an effective method of treatment of bilateral xanthogranulomatous pyelonephritis in a 6-year-old boy. Hyla-Klekot, Lidia; Kucharska, Grazyna; Paradysz, Andrzej; Pindycka-Piaszczynska, Malgorzata // Central European Journal of Urology;Jun2009, Vol. 62 Issue 2, p118 

    Xanthogranulomatous pyelonephritis is an extremely rare form of tubulo-interstitial nephropathy, characterized by the progressive destruction of the renal parenchyma, which is then replaced by the xanthogranulomatous tissue. This process is usually present in one kidney and in the perirenal fat...

  • Laparoscopic Nephron-Sparing Calycectomy for Treating Fraley’s Syndrome. Porpiglia, Francesco; Bertolo, Riccardo; Checcucci, Enrico; Amparore, Daniele; Manfredi, Matteo; Fiori, Cristian // Urologia Internationalis;Feb2018, Vol. 100 Issue 2, p134 

    Background/Aims/Objectives: Various nephron-sparing approaches were described as part of surgical management for Fraley’s syndrome, a rare anatomic variant of the renal vascular anatomy that compresses the upper pole infundibulum resulting in...

  • Update on the management of renal trauma. Rosenstein, Dan; McAninch, Jack W. // Contemporary Urology;Jul2003, Vol. 15 Issue 7, p42 

    Details the management of patient with renal trauma aimed at preventing hemorrhage and retaining sufficient functioning nephron mass to avoid end-stage kidney failure. Percentage of renal injuries that result from blunt trauma; Categories of renal injuries that need radiographic imaging;...

  • Glomerular protein sieving and implications for renal failure in Fanconi syndrome. Norden, Anthony G.W.; Lapsley, Marta; Lee, Philip J.; Pusey, Charles D.; Scheinman, Steven J.; Tam, Frederick W.K.; Thakker, Rajesh V.; Unwin, Robert J.; Wrong, Oliver // Kidney International;Nov2001, Vol. 60 Issue 5, p1885 

    Glomerular protein sieving and implications for renal failure in Fanconi syndrome. Background. Glomerular sieving coefficients (GSCs) of proteins have been measured extensively in animals but not humans. We have studied the proteinuria of Fanconi syndrome, a “knock-out” of renal...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics