Central renal cell carcinoma: a diagnostic dilemma

Abstract

Centrally Located renal tumor poses a diagnostic challenge to differentiate between renal cell carcinoma and transitional cell carcinoma. Imaging alone is not sufficient to make the diagnosis, some invasive diagnostic investigations are required to ascertain the diagnosis. We present a 60 years old gentleman, who presented dyspepsia and further investigation by contrasted CT kidney revealed a centrally located right renal tumor. Before making a management decision, we performed the right renal biopsy of the tumor which turns out to be a renal cell carcinoma. Henceforth, we performed a robotic-assisted laparoscopic right nephrectomy. A renal biopsy, in this case, assisted to decide only radical nephrectomy instead of radical nephroureterectomy which has higher associated morbidity. Thus, it is important to make confirm by tissue biopsy before deciding on surgery in case of the central renal tumor as this prevents subjecting a patient to under-or overtreatment.