Abstract

PEREIRA ARIAS, José Gregorio et al. Concurrent tumors in a patient with giant hydronephrosis. Arch. Esp. Urol. [online]. 2006, vol.59, n.1, pp.84-87. ISSN 0004-0614.

OBJECTIVES: Giant hydronephrosis, defined as the presence of a liquid volume over 1000 ml within the urinary collector system, is a rare clinical entity, the diagnosis of which is an excellent exercise because it lacks of a defined clinical presentation. Methods/Results: We report the case of a 66-year-old male under study for a suspicious digestive tumor due to a long lasting clinical picture with severe cachexia, asthenia, anemia , constipation, and abdominal mass. Radiological tests showed a great right hydronephrosis secondary to a culculus in the ureteral-pelvic junction. Simple nephrectomy was performed, evacuating 7800 ml of serous-hematicliquid from the pyelocalicial system. A histological diagnosis revealed the presence of multiple foci of transitional cellcarcinoma and renal cell carcinoma associated. We review the diagnostic and therapeutic features in the literature. Conclusions: Giant hydronephrosis represents adiagnostic dilemma. It may present as an asymptomatic process, with clinical features of abdominal organscompression (bowel or urinary obstruction) or simulateabdominal tumors, massive ascites, or cystic retroperitoneal lesions. Simple nephrectomy is the treatment of choice in most cases, due to the advanced deterioration of the renal unit. Nevertheless, in some cases, in compromised patients, percutaneous drainage may be necessary as previous or definitive treatment to avoid changes in the hemodynamicbalance secondary to the sudden abdominal decompression.

Keywords : Giant hydronephrosis.

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