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Renal Cell Carcinoma
Center of Excellence
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George Magalhães
Apr 16, 2015
Is There Any CT scan image available of the present case?
Bogdan Cristian Dinu
Apr 17, 2015
I think if the state despite the size of tumour permited nephrectomy go ahead and afterthat to treat she with TKI
Andrew Fintel
Jun 30, 2015
Do we know what this patient's performance status is, hemoglobin, LDH, calcium so as to gain insight into her overall prognosis? Her significant weight loss alone is a poor prognostic feature. It does not seem from the presentation that this patient has a good performance status and certainly is high risk for any surgical intervention given the vascular history of the patient, her being on blood thinners, and having a long history of smoking.
The NCCN panel does recommend palliative nephrectomy for patients with symptoms like hematuria, but these must be weighted against the risk of the surgery, and her risk seems to be high.
Another option associated with less complications would be to embolize the source of her bleeding...typically using ethanol. I think in her case if surgery is not a reasonable option, then embolization would be a good option.
Apr 19, 2024
Pending Moderator approval.
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Tony
Nimeh
MD
George Magalhães
Apr 16, 2015
Bogdan Cristian Dinu
Apr 17, 2015
Andrew Fintel
Jun 30, 2015
Apr 19, 2024
Pending Moderator approval.