Carcinoma de células renales bilateral y asincrónico: Cirugías radical y conservadora con hipotermia in situ

objectives: to present the double action a urologist has to consider in front of a renal cell carcinoma (rcc); on one hand, when the normality of the contralateral kidney is stated and, on the other hand when, forced by the existence of the tumor in a solitary kidney, it is mandatory to perform a surgical technique to preserve renal function. method: the case of a 43 year-old patient, diabetic who in 1982 underwent left radical nephrectomy for rcc diagnosed during a diagnostic work up for hypertension (hta). ten years later an upper pole renal tumor is found in the remaining kidney. nephron-sparing surgery with in situ hypothermia was performed. results: the patient died 18 years after the first surgery and 8 years after the second. death was due to diabetic decompensation, haemorrhage from a gastric ulcer and "retroperitoneal mass probably pancreatic" that was not characterized. conclusions: the psa decline, the histology of the prostate during the adenomectomy and the morpho-metric changes after surgery and at mid-term, advise a more accurate value of psa in patients who underwent open surgery, in order to detect a carcinoma in the residual prostate gland.