New Delhi/NCR, 7th March 2018: Timely detection of disease and opting for the correct line of treatment helped a 45-year-old woman from Gannaur, Haryana to get rid of a ruptured Kidney Tumour (Cancer). Doctors at Fortis Hospital, Shalimar Bagh performed a Left Radical Nephrectomy (removal of the whole kidney with surrounding tissues) on a patient who had a developed a left ruptured kidney mass and was found to have a ruptured and bleeding left a kidney tumour. The team of Doctors led by Dr. Rajinder Yadav, Director Urology, and Kidney Transplant ensured a timely diagnosis and treatment. Early detection of the tumour served as an important reason for recovery as it ensured the correct treatment for the tumor which was given to the patient, a tumour which is very rare, especially in the middle-aged women.
Mrs. Darshan Devi, 45 years of age was presented to Fortis Hospital, Shalimar Bagh, New Delhi, on an emergency basis in late January 2018 with a complaint of on and off bleeding in the urine for past 2 months. She also complained of pain in the back and left side of abdomen for one day. On evaluation, she was found to have ruptured and bleeding left a kidney tumour with collected blood clots within left kidney and surrounding tissues. What made matters complicated was that due to continuous bleeding in urine for a long time, the patient had suffered huge blood loss, as a result, her hemoglobin was very low and was unfit for any major surgery. The patient also had very high blood sugar due to uncontrolled diabetes which needed to be controlled first, therefore could not be operated immediately. The Patient first had to be stabilized for her low hemoglobin and raised blood sugar. The bleeding had to be stopped and her hemoglobin level had to be increased by transfusing blood. Moreover, her blood sugar had to be brought down to a normal level as it entailed anesthetic and intraoperative cardiac risks.
To stop the ongoing bleeding, blockage of the left renal artery was done under X-Ray imaging (Angiography), which helped to stop the bleeding from the tumour and the patient could be taken up for the surgery. After the bleeding from the tumour was stopped, she was transfused blood to increase the hemoglobin level. She underwent Left Radical Nephrectomy (removal of kidney along with surrounding tissues) with open abdomen incision. During surgery, her left kidney blood vessels were secured carefully so as to avoid any further injury to renal and other larger blood vessels. The left kidney with ruptured tumour and surrounding tissues along with the clotted blood was removed. In post- operative period patient was kept in ICU for one day while she was intubated (in view of poor chest condition and huge blood loss). Her tumour was removed completely and now the patient is doing well. Her postoperative PET CT scan (reports) show no further residual tumour in body and she is now healthy and tumour-free.
Dr, Rajinder Yadav, Director Urology and Kidney Transplant said, “This is one of the very rare presentations of the Kidney Tumour and even more rare in the middle aged women. The average age of people diagnosed with Kidney Cancer is above 60 years of age. To be diagnosed with bleeding tumour at 45 is a rare site in women. The patient never complained of any kidney related ailment in the past. Such a tumour has no significant signs and often do not cause much pain. However, if while urinating there is bleeding or pain, one should immediately consult a doctor. In the present scenario, it was only through timely diagnosis that the patient could be cured as there are no substantial other symptoms. It is advised to get timely screened to identify such a fatal tumour. Had the patient not been diagnosed and treated timely, the tumour would have cost the patient her life “
Mrs. Darshan Devi said, “I had on and off painless bleeding in the urine for the past two months. Being at the age of Menopause, I could not identify the reason and dismissed it as regular periods. It was after ongoing blood loss that I realised that this was no regular bleeding. It was only through the timely diagnosis that the Doctors found out that I had Kidney Cancer. Such a diagnosis has made me realise how women ignore the signs of their own body and do not take blood in urine to be cancerous. My diagnosis has helped me reach younger and middle aged woman to read their body signs and make them aware of the importance of regular and timely screening.”
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Tituraj Kashyap Das
Senior Manager, Corporate Communication
Fortis Healthcare Limited