Outcome of delayed presentation in patients with giant renal cell carcinoma: A case report

Introduction and importance: Renal cell carcinoma (RCC) is a common form of malignancy that causes many deaths worldwide. One of the RCC cases that is challenging and requires proper treatment is a large tumor. This report explores the delayed presentation and treatment of giant RCC.

Case presentation: A 53-year-old man came to the referral hospital with a mass in the left pelvis 10 years ago. The patient had been experiencing left flank pain and intermittent hematuria for the past 6 months. Physical examination showed an abdominal mass 20 × 26 cm, cystic consistency, and fixed. A Computed Tomography (CT) scan of the abdomen showed a cystic mass measuring 9.5 × 22.7 × 26.37 cm. The patient underwent a left radical nephrectomy with a chevron incision. The kidney mass was completely removed, and no residual mass or other bleeding was found from the evaluation results. The patient was discharged on the 3rd day after surgery.

Clinical discussion: There was a delay in early detection so the tumor size became large. RCC is considered rare because of its slow growth rate and early detection with imaging techniques. Nephrectomy is the recommended treatment option. All patients should undergo long-term surveillance with routine imaging after nephrectomy to detect recurrent disease early, in this case, the patient is routinely examined every 6 months at follow-up visits.

Conclusion: Once a case of giant renal cancer is diagnosed, immediate action must be taken to avoid patient morbidity and mortality.