Yun JK, Kim SH, Kim WB, Kim HK, Lee SW. Simultaneous robot-assisted approach in a super-elderly patient with urothelial carcinoma and synchronous contralateral renal cell carcinoma: A case report. World J Clin Cases 2022; 10(20): 7153-7162 [PMID: 36051108 DOI: 10.12998/wjcc.v10.i20.7153]
Corresponding Author of This Article
Sang Wook Lee, MD, Associate Professor, Department of Urology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Jomaru-ro 170, Wonmi-gu, Bucheon 14584, South Korea. bartol@schmc.ac.kr
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 16, 2022; 10(20): 7153-7162 Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.7153
Simultaneous robot-assisted approach in a super-elderly patient with urothelial carcinoma and synchronous contralateral renal cell carcinoma: A case report
Ji Kang Yun, Si Hyun Kim, Woong Bin Kim, Hee Kyung Kim, Sang Wook Lee
Ji Kang Yun, Woong Bin Kim, Sang Wook Lee, Department of Urology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon 14584, South Korea
Si Hyun Kim, Department of Urology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan 31151, South Korea
Hee Kyung Kim, Department of Pathology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon 14584, South Korea
Author contributions: Yun JK and Lee SW designed the study; Yun JK, Kim SH, Kim WB, Kim HK, and Lee SW contributed to the data collection and curation; Yun JK, Kim SH, Kim WB, and Lee SW contributed to the data validation and investigation; Yun JK and Lee SW analyzed the data and wrote the manuscript; Yun JK, Kim SH, and Lee SW reviewed and edited the manuscript; All authors have read and approved the final manuscript.
Supported bySoonchunhyang University Research Fund, No. 1022-0015.
Informed consent statement: Informed consent has been obtained by research participant in a face-to-face interview using written paper consent forms.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sang Wook Lee, MD, Associate Professor, Department of Urology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Jomaru-ro 170, Wonmi-gu, Bucheon 14584, South Korea. bartol@schmc.ac.kr
Received: February 17, 2022 Peer-review started: February 17, 2022 First decision: March 24, 2022 Revised: April 4, 2022 Accepted: May 22, 2022 Article in press: May 22, 2022 Published online: July 16, 2022 Processing time: 137 Days and 12.7 Hours
Abstract
BACKGROUND
It is rare for urothelial and renal cell carcinomas to coexist in the same patient, and even rarer for them to be detected simultaneously. Because of this rarity, a standard treatment has not been established and studies about overall survival are scarce. Therefore, physicians must modify treatments according to the individual’s situation and the stage of each disease. In recent years, with advances in the instruments and techniques, minimal invasive robotic surgeries have become available for advanced-stage or high-risk patients.
CASE SUMMARY
An 85-year-old woman with a medical history of hypertension and hyperlipidemia visited our institution. She had visited her local hospital complaining of intermittent, painless, gross hematuria that had started 3 mo earlier. On computed tomography, a right renal mass and left proximal ureteral mass with hydronephrosis were found simultaneously. We decided to perform robot-assisted surgery on both sides during one operation. Considering renal function and kidney loading, right partial nephrectomy was performed first, followed by left nephroureterectomy with bladder cuff excision. At the 6-mo follow-up, no specific symptoms were reported and dialysis was not considered. There were no unusual findings in the imaging study, and regular follow-up and imaging studies are scheduled.
CONCLUSION
This case report assessed the feasibility of simultaneous minimal invasive robotic surgery as an alternative to conventional open or laparoscopic surgery.
Core Tip: Upper tract urothelial carcinoma with synchronous contralateral renal cell carcinoma is extremely rare and seldom reported. There have only been a few reported cases or a small series. Therefore, no effective standard treatment has been established. In high-risk patients with multiple comorbidities or the super elderly, a conventional open or laparoscopic approach to bilateral tumor lesions can be burdensome to both patient and surgeon, considering perioperative or postoperative complications. This case report might present an attractive treatment option using a minimal invasive robot-assisted approach done simultaneously at once, and suggests that these methods can be used more widely.
