Kidney Cancer Treatment at Institute of Urology, Jaipur: We present the case of a 56-year-old male with a right renal mass diagnosed radiologically as a suspected transitional cell carcinoma (TCC) at the pelvi-ureteric junction (PUJ). A laparoscopic radical nephroureterectomy was successfully performed at the Institute of Urology, Jaipur, utilizing state-of-the-art minimally invasive techniques. The patient had a smooth postoperative recovery, reinforcing the efficacy of advanced urological surgical care delivered at our institute.
Introduction
Upper tract urothelial carcinoma (UTUC), particularly those arising at the pelvi-ureteric junction, pose significant diagnostic and therapeutic challenges. Radical nephroureterectomy remains the gold standard for high-risk lesions. Minimally invasive techniques, such as laparoscopic nephroureterectomy, are increasingly favored due to lower morbidity, faster recovery, and superior cosmetic outcomes.
At the Institute of Urology, Jaipur, we are equipped with advanced laparoscopic technology and highly skilled surgeons, enabling us to manage such complex cases effectively and efficiently.
Case Presentation
A 56-year-old man was referred to the Institute of Urology, Jaipur, with an incidental finding of a right renal mass. The patient was asymptomatic, with no history of hematuria, flank pain, or urinary tract infections.
Radiological Findings
A contrast-enhanced CT scan of the abdomen and pelvis revealed a polypoidal soft tissue mass at the right pelvi-ureteric junction, causing moderate hydronephrosis. The lesion was non-calcified and enhanced post-contrast, raising suspicion for upper tract malignancy, most likely transitional cell carcinoma (TCC). The left kidney was normal in function and structure, apart from a few Bosniak type I–II simple cysts.
Management and Surgical Approach
After thorough counseling with the patient and his family regarding treatment options and outcomes, a laparoscopic radical nephroureterectomy was planned and executed. The decision for laparoscopic surgery was based on the patient’s general health, radiological findings, and our commitment to minimally invasive techniques that reduce patient trauma, hospitalization time, and postoperative discomfort.
The procedure was performed under general anesthesia. The entire kidney, ureter, and a cuff of the bladder were removed en bloc using laparoscopic access. Intraoperatively, the lesion was confined to the upper tract with no gross evidence of extra-urinary spread.
The removed specimen (kidney and ureter), shown in the figure below, was sent for histopathological examination.
Postoperative Outcome
The patient recovered uneventfully. Pain was minimal, ambulation was initiated within 24 hours, and oral intake resumed promptly. The patient was discharged on the third postoperative day with instructions for routine follow-up and histopathological review.
He continues to do well, with no signs of recurrence or complications as of the last follow-up visit.
Discussion
This case underscores the importance of prompt and accurate evaluation of upper urinary tract lesions. Given the location and morphology of the mass, the likelihood of UTUC was high, and a radical nephroureterectomy was the most definitive approach.
The Institute of Urology, Jaipur continues to be at the forefront of minimally invasive urological surgery. Our world-class infrastructure, combined with the unmatched surgical expertise of Dr. M. Roychowdhury and Dr. Rajan Bansal, ensures high standards of patient care and optimal outcomes.
Their proficiency in laparoscopic and endourological techniques enables the institute to offer cutting-edge care across a wide spectrum of urological disorders. This case is another testament to the commitment to precision, patient comfort, and oncological safety.
Conclusion
Laparoscopic radical nephroureterectomy offers a safe and effective treatment for upper tract malignancies. In the hands of expert surgeons, it ensures complete oncological control with the added benefit of minimal invasiveness. The success of this case further highlights the advanced surgical capabilities and excellence in urological care available at the Institute of Urology, Jaipur.
