RESUMEN
Renal cell carcinoma without metastasis responds well to surgical excision but is known to recur postnephrectomy. In a small but significant number of patients this recurrence is not accompanied by metastasis, which is important as these people benefit from further surgery. We examined 20 articles from the current literature to ascertain how best to treat this condition. Surgical management renders better results than conservative or medical therapies. Readily available investigations such as blood tests and computed tomography can help determine the right patients for surgery in an evidence-based fashion. Current findings have allowed us to suggest a protocol for the treatment of solitary renal fossa recurrence of postnephrectomy renal cell carcinoma. There are further opportunities for study in validating our protocol, and in novel renal cell carcinoma treatment strategies that have not been tested on solitary renal fossa recurrences.
RESUMEN
A 74-year-old man presented with a history of collapse and abdominal pain. Initial imaging showed a left sided preirenal collection. The initial working diagnosis was perirenal hematoma secondary to renal trauma. Subsequent patient deterioration led to further imaging which led to the diagnosis of a duodenal perforation with tracking of duodenal contents into the left perirenal space. This important differential should be a consideration in cases of perinephric collections of unknown etiology.
