Posted by Marcian Antonio Manu - Bucharest on May 12, 1999 at 00:40:29:
In Reply to: Yet another RCC posted by Chit Sin on May 11, 1999 at 07:41:38:
: 61 year old man. Radical left nephrectomy 18 month ago for RCC. Known lesion in segment 5 of liver pre-op which was cystic on USS. Clinically well and gaining weight Good performance status. Latest CT showed a solid mass (2x3cm) in the left crus of the diaphragm. Liver lesion very slightly bigger. What would you do next?
What stage was the tumour ?
Could be another pathology than cancer in the crus ? Very low probability. If his condition is so good and he doesn't have other signs of metastasis it could be tried exploratory surgery, eventualy a toumorectomy of the crus. If he is lucky, the resection could be radical and if he doesn't have other microscopicaly dissemination ( again low probability), maybe he has a chance. In my department in Bucharest I've seen more than a few cases reoperated for different metastasis ( surgery by request, family, etc....) and almost all them were useless. Here in Japan where I am working now, they practice TIL therapy , Interleukine 2 and Interferon. As in your country is, also in Romania the cost of these treatments is prohibitive, so that I don't have a good personal experience. So that we have to do what we can do.....surgeryDWe could talk about biopsy CT controlled. I don't know if the laparoscopic aproche is technicaly possible after a previous surgery in this area.