Chennai, 23rd December 2024 : Kauvery
Hospital Vadapalani, a leading healthcare institution in Chennai, has treated
an exceptionally rare case tumor in the abnormal kidney in lower abdomen tumor and bladder tumor in an 85-year-old diabetic
patient. The case, which
involved complex urological conditions, marks a significant achievement in the
hospital’s
advanced medical capabilities, especially in the field of minimally invasive
surgery. The treatment was led by Dr. Aarthy P, Consultant Urologist and
Robotic Surgeon, known for her expertise in complex urological conditions.
The patient, an
85-year-old male with a longstanding history of diabetes, was referred to
Kauvery Hospital after presenting with hematuria (blood in the urine) and an
abnormal located kidney identified in an ultrasound performed at another
hospital. The initial diagnosis suspected an infection in the right kidney, but
further investigation revealed a far more complex condition.
At Kauvery Hospital, a
comprehensive series of diagnostic tests were carried out, including advanced
imaging and endoscopy. These revealed not only a bladder tumor but also a tumor
in an ectopic pelvic kidney – a kidney located abnormally in the lower abdomen
rather than the upper abdomen where the kidney is usually situated. This discovery led
to the diagnosis of a of urothelial carcinoma both in the kidney and bladder , a cancer that originates in the lining of
the urinary tract, both in the kidney and bladder.
"This is an
extraordinarily rare condition," said Dr. Aarthy P., Consultant Urologist
and Robotic Surgeon. "To find urothelial tumor inside ectopic kidney at
the same time is something we rarely encounter in clinical practice. The
condition had only been reported in a handful of cases worldwide, and in India,
there have been only 3-4 such instances.”
Given the complexity of
the case, the team opted for a minimally invasive approach to surgery, aiming
to reduce the patient’s
post-operative pain, speed up recovery, and ensure the best possible outcomes. The team performed a
Endoscopy Removal of Bladder tumor (TURBT) laparoscopic right
nephrouretercetomy (removal of the kidney & Ureter ) with lymph node dissection, using
only three small incisions of approximately 1 cm each. This technique, known as
laparoscopic surgery, avoids large incisions and muscle cutting, significantly
reducing the trauma to the body.
This laparoscopic
approach allowed us to remove the kidney and the tumor with minimal disruption
to the surrounding tissue. The patient’s
recovery was swift and remarkably comfortable. He experienced very little pain
post-surgery and was able to return to his daily activities sooner than we
expected. In addition to the nephrectomy, the patient also received
intravesical therapy, a treatment where medication is administered directly
into the bladder, to prevent the recurrence of the bladder tumor. The surgical
procedure and subsequent treatments were carried out with the utmost precision,
with the aim of offering the best chance for long-term survival.
Following the surgery,
the patient experienced a smooth recovery, although his pre-existing diabetes
led to some complications in the form of diabetic ketoacidosis (DKA), a serious
condition that can develop in people with uncontrolled diabetes. However, with
the swift intervention of the medical team, the patient’s
DKA was successfully managed, and he made a full recovery.
Postoperative pathology
confirmed that the tumors were high-grade, indicating a more aggressive form of
cancer. As a result, the patient will require chemotherapy in the near future
to reduce the risk of recurrence and improve his long-term prognosis.
Dr. Aravindan Selvaraj,
Co-Founder & Executive Director Kauvery
Group of Hospitals said, “This is one of the rarest cases we have encountered,
and performing such a surgery with minimally invasive techniques is a
significant achievement. There are only 3-4 reported cases of this condition in
India, and the surgical approach we used has been proven to be highly
effective. The patient is doing well post-surgery and is expected to continue
his recovery under our careful supervision. Cases like these challenge us as
medical professionals to constantly innovate and adapt. The techniques and
insights gained from this procedure will help improve the care of future
patients with similar conditions."
Kauvery Hospital,
Vadapalani, has long been known for its state-of-the-art medical facilities and
commitment to providing the highest standard of care. The hospital's urology
department, led by a team of highly skilled surgeons, offers specialized
treatments for a range of complex urological conditions, including cancers of
the kidney, bladder, and prostate.