title: Metastatic cancer to the renal pelvis: a novel approach to management.
abstract: We describe a novel application of percutaneous renal surgery for the management of an unusual and challenging urologic problem. Two patients with symptomatic, metastatic adenocarcinoma in the renal pelvis were treated with percutaneous resection. The lesion was in a solitary kidney in 1 patient, and was bilateral in the second. Percutaneous resection resulted in complete relief of symptoms and obstruction. Although both patients ultimately died of their primary disease, their quality of life was significantly improved in the interim. Percutaneous resection of renal pelvic tumors is accepted management for select patients with upper tract transitional cell carcinoma. These 2 cases demonstrated both an unusual presentation for metastatic adenocarcinoma and an expanded application for percutaneous renal surgery.
authors.affiliation: Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195-5041, USA.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Milbank
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Savage
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Angermeier
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Ng
authors.forename: Stevan B
authors.initials: SB
authors.lastname: Streem
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000556:secondary; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000556:secondary; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery; D019090:Case Management; D042883:Choledocholithiasis / Q000150:complications; D003110:Colonic Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D003131:Combined Modality Therapy; D004067:Digestive System Neoplasms / Q000556:secondary; D004724:Endoscopy; D017809:Fatal Outcome; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007680:Kidney Neoplasms / Q000556:secondary* / Q000601:surgery; D007682:Kidney Pelvis / Q000473:pathology* / Q000601:surgery; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D009392:Nephrectomy; D009403:Nephrostomy, Percutaneous; D010166:Palliative Care; D011788:Quality of Life