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Spontaneous Renal Tumour Regression Following An Aortic Dissection

Schaschula, 2024Kidney cancer

Schamschula, J., Young, S., & Pridgeon, S. (2024). Spontaneous renal tumour regression following an aortic dissection. Annals of the Royal College of Surgeons of England, 106(1), 96–98. https://doi.org/10.1308/rcsann.2022.0134

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Abstract

Spontaneous tumour regression is a rare but well-documented phenomenon, especially for renal cell carcinomas. We describe the case of a 60-year-old male who presented with chest pain and shortness of breath. He was diagnosed with a large type A aortic dissection and an incidental right renal mass, highly suspicious of a renal cell carcinoma. Following repair of the dissection, subsequent imaging showed that the renal mass had largely resolved. Spontaneous tumour regression is commonly thought to occur through immunological mechanisms. A vascular cause of tumour regression through infarction is postulated in this case. Although angioembolisation is a well-recognised management option in the context of palliative treatment of symptomatic renal tumours, this case suggests an extended role for angioembolisation in the treatment of small renal masses.

Case Details

Disease Location

Kidney

Personal Characteristics

60-year-old male. History of obesity, hypertension, and left ventricular hypertrophy.

Clinical Characteristics

Presented with chest pain and shortness of breath. CT scan showed a type a aortic dissection from the aortic root extending proximally into the pericardium and distally into the right renal artery. A 47×37×46mm tumour was found on the upper pole of the right kidney. The patient underwent emergent surgical repair of the aortic dissection.

Remission Characteristics

CT scan undertaken 11 months later revealed the right renal mass had largely regressed

Treatment & Mechanisms

Proposed Remission Mechanisms

The renal artery dissection compromised the tumour feeding vessel with thrombosis and infarction, causing spontaneous tumour regression.

Clinical Treatment

Aortic dissection repair