Osman KÖSE, Sıtkı ÜN², Alper Cihat ERDAL, Ahmet Selçuk DİNDAR, Yüksel YILMAZ

Böbreğin Primitif Nöroektodermal Tümörü: Rezektabl Olmayan Bir Tümörde Neoadjuvan Kemoterapinin Başarısı

Amaç: Böbreğin primitif nöroektodermal tümörü oldukça seyrek ve agressif davranışlı ve kötü prognozludur. Olgu: 26 yaşında erkek hasta, hafif sağ yan ağrısı, mikroskopik hematüri ve hafif kusma yakınmaları ile kliniğimize refere edildi. BT de; 17X13X18 cm boyutlarında, sağ böbreği tümüyle saran ve sağ hipokondriumu dolduran bir tümör saptandı. Tümör, karaciğer yüzeyinden ve duodenumdan disseke edilemediği için eksize edilemedi, eksizyonel biyopsi yapılarak operasyon sonlandırıldı. IE/VAC alterne kemoterapi 7 siklus boyunca uygulandı. Tedavinin 5. ayında çekilen PET-CT de tümörün 8X6X7 cm boyutlarına küçüldüğü gözlendi. Herhangi bir komşu organa zarar verilmeden radikal nefrektomi yapıldı. Sonuç: Bu tip tümörlerde neoadjuvan kemoterapi, radikal nefrektomi öncesinde kitle küçültmek amaçlı olarak kullanılabilir.

Anahtar Kelimeler:

nöroektodermal tümör, böbrek, neoadjuvan kemoterapi

Primitive Neuroectodermal Tumor of Kidney: success of neoadjuvant chemotherapy in an unresectable tumor?

Objective: Primitive neuroectodermal tumors PNET of the kidney are very rare tumors with aggressive behavior. They usually are associated with poor prognosis. Case: A 26-year old male patient presented to our clinic with right flank pain, microscopic hematuria and moderate-heavy nausea complaints. CT imaging studies showed a tumor with 17x13x18 cm dimensions. A mass excision was not possible caused by tumor spread to liver surface and duodenum and the tumor could not be separated from these surfaces. The operation was finished with an excisional biopsy. The patient received 7 cycles of alternating IE/VAC chemotherapy sessions. At 5th month of follow-up, PET-CT scans showed that the tumor was regressed to 8x6x7 cm dimensions. Following this outcome, radical nephrectomy was performed without risking any other organs. Conclusion: Neoadjuvant chemotherapy can be employed prior to radical nephrectomy in such cases in order to radically/efficiently/ drastically reduce the tumor mass

Keywords:

neuroectodermal tumor, kidney, neoadjuvant chemotherapy,

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