Two Rare Examples of Extremely Indolent Nature of Renal Cell Carcinoma-Tumours Resectable and Curable Ten Years after Initial Diagnosis

Abstract

We report two cases of renal cell carcinoma (RCC) that were amenable to surgical resection and cure 10 years after diagnosis. One of the cases was a 34 years old male who performed general duties in Army. He presented with left flank pain, fever, and loss of appetite of 10 days duration and on clinical examination, had a firm, non tender lump palpable in left lumbar region. The second case was 45 years old lady, a housewife, who presented with a large left flank lump. Further clinical and radiological evaluation revealed that the tumours were confined to Gerota's fascia with no evidence of lymph node or distant metastasis in either of the cases. More importantly, both the patients were found to have been diagnosed with renal tumours ten years earlier as was evident from their past medical records and old imaging, although the tumour size was relatively smaller at that time. Both the patients, however, had defaulted from undergoing surgery. They underwent radical nephrectomy at our centre and histopathological examination revealed Furhmann Grade II clear renal cell carcinoma (Stage-T2bN0M0 in the first case and Stage-T3b N0 M0) in the second case. The first case has completed two years and the second case, one and half years, respectively, of follow up and is recurrence free. There is no other reported case of renal cell carcinoma in the published literature that were left untreated for ten years and still remained not only resectable but curable also.