Objective: This article is aimed to report an unusual presentation of renal cancer T4N0M0 in which the tumor weighed about 5 kilograms in a patient admitted to Urology Department of Hasan Sadikin Hospital in Bandung, Indonesia, in August 2016. Case presentation: We report a case 62 year old male with history of growing mass in his left abdominal. There are also painless hematuria and weight loss of approximately 10 kg over the past 2 years. Discussion: Physical examination found a significant palpable, immobile and mild tender mass in the left upper quadrant of the abdomen. Abdominal Pelvic Computed Tomography (CT) scan revealed inhomogenous hypodens mass in the left kidney. Resection of the tumor revealed a 5 kg (22 x 25 x 18 cm, with total volume of 9.900 cm3) encapsulated neoplasm. Histophatological examination revealed a clear cell type renal cell carcinoma (RCC) with positive margin and Fuhrmann grade 2. In Asia, a giant chromophobe RCC exceeding 10 kg in weight was reported in 2009. As for previously reported giant clear cell RCC, we found out the data to be very limited. Conclusion: Giant RCC is rare, especially clear cell type in histophatological result. The size of the tumor reported in this article is considered as the largest-sized giant clear cell RCC ever reported in Asia. The size of the tumor in this case presented several challenges in the operative settings. However, the outcome and six months post-operative follow-up of the patient was satisfying in which there was no presence of single symptom within the six-month follow-up period.
Bladder cancer is the 10th most common cancer in both males and females with a ratio of 3:1. About 75% of bladder cancers are non-muscle invasive bladder cancers (NMIBC). The aim of this study was to identify the characteristics of Non-Muscle Invasive Bladder Cancer (NMIBC) patients treated in Dr. Hasan Sadikin General Hospital as one of the tertiary hospitals in Indonesia. This was a retrospective descriptive study that involved reviewing the medical records of patients diagnosed with NMIBC between January 2008 and December 2019. Characteristics reviewed were age, gender, body mass index (BMI), smoking history, urinary tract infection and stone history, intravesical chemotherapy and its side effects, and urinary cytology results. All data were tabulated and charted. Fifty-one out of 773 bladder cancer patients were diagnosed with NMIBC (6.59%). The mean age was 62.94 years old, with the majority of patients were in the 60-69 age group (31.37%). Males constituted the majority of the patients (n=44, 86.27%), with most patients had ideal BMI (66.66%), smoking history (72.54%), urinary tract infection history (56,86%), and urolithiasis history (5.88%). Thirty patients were given intravesical chemotherapy (58.82%), three patients experienced hematuria (10%), and four patients had painful urination (13.33%). Urinary cytology showed atypical cells (92.16%) in the majority of patients. The incidence of NMIBC in bladder cancer patients in our study was 6.59%, which differs from the incidence in developed countries of 75%, as shown in previous literature.
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