Hand-Assisted Laparoscopic Partial Nephrectomy for Large Renal Carcinoma with Succinate Dehydrogenase Deficiency

Abstract

Background: Germline mutations in succinate dehydrogenase (SDH) are associated with multifocal cancers: pituitary gland tumors, pheochromocytomas, paragangliomas, gastrointestinal stromal tumors, and renal-cell carcinomas (RCCs). SDH-deficient renal-cell carcinoma (SDH-RCC) was first identified in 2004 as an inherited kidney cancer with mutations in the SDH gene. SDH consists of A, B, C, and D units. Mutation in the SDHB gene is the most common mutation in SDH-deficient RCCs.Case Presentation: We report a case of a 51-year-old healthy man diagnosed with SDHB germline mutation and RCCs. Positron emission tomography/computed tomography (PET/CT) showed a 12 cm tumor in the upper pole of the left kidney. A hand-assisted laparoscopic partial nephrectomy was performed and the histopathology of the tumor showed SDH-deficient RCC with clear surgical margins. Six months after the initial presentation, the patient had a slightly impaired renal function and was disease-free on PET/CT.Conclusion: Patients with SDH-deficient RCC are at risk of multifocal kidney tumors and should be offered lifelong follow-up. To preserve the renal function, nephron-sparing surgery is the choice of treatment when feasible, regardless of tumor size.

Effects of ultrasound waves on rat liver mitochondria

“…Succinate dehydrogenase (SDG), widespread in plant and animal cells and located in the inner mitochondrial membrane, is a key enzyme in energy metabolism [7]. SDG catalyzes the conversion of succinate to fumarate in the Krebs cycle, with the resultant electrons being transferred to complex III of respiration to reduce oxygen and produce water [8].…”