Diagnostics and orthopaedic treatment of the renal cancer consequences illustrated with an example of a clinical case
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Oddział Chirurgii Urazowej i Ortopedii 7. Szpitala Marynarki Wojennej w Gdańsku; ordynator: lek. Piotr Zawadzki
Zakład Medycyny Morskiej i Hiperbarycznej Wojskowego Instytutu Medycznego w Gdyni; kierownik: prof. dr hab. n. med. Romuald Olszański
Zakład Podstaw Chirurgii i Urazu Wielonarządowego Gdańskiego Uniwersytetu Medycznego; kierownik: prof. dr hab. n. med. Jerzy Lasek
Oddział Onkologii i Radioterapii, Pomorskie Centrum Onkologii w Gdyni; ordynator: dr n. med. Krzysztof Leśniewski‑Kmak
Submission date: 2018-09-17
Publication date: 2018-12-10
LW 2019;97(1):41–49
A 51‑year‑old female, physically and professionally active, suffered a pathological fracture of the right humerus, after which diagnosis and treatment have been implemented. Metastases were found in vertebrae C 6–7, Th 1–12, L 1–5, S 1–2, the right humerus, left humerus, right hip bone, left femur, and the probable primary focus in the left kidney was identified. There were pathological fractures of Th3, Th10, and both the right and left humeruses. The patient was treated surgically: right humerus – open repositioning and fixation with an LCP plate and screws with bone substitute material with tissue material forwarded to histopathological examination, left humerus – excision of the tumor focus around the pathological fracture of the left humerus with an LCP plate and screw fixation filled with bone cement. Left kidney tumor excision – primary focus. Vertebroplasty of vertebrae L1, L4, L5.The histopathological examination revealed an undetermined Renal Cell Carcinoma, though a translocation RCC was suspected. She was treated with radiotherapy of metastase foci and immunomodulator – Sunitinib. The patient was treated conservatively due to secondary anemia, pain syndromes and muscular contractures. Metastases in the lungs, liver and spleen were revealed. She died a year after the diagnosis. Invasive treatment improved the patient’s physical condition, restoring her life activity. It was not possible to stop the spread of cancer, which led to multi‑organ failure and consequently to her death.
No conflicts of interest were declared.