Case History (164 words):
Before undergoing kidney transplantation, a 70-year-old female with
end-stage renal failure secondary to ADPKD was admitted for bilateral
nephrectomy due to significant nephromegaly. Her past medical history
included a stage I myxoid liposarcoma of the left leg, removed 4 years
earlier, a pacemaker for an atrioventricular block and high blood
pressure necessitating four antihypertensive medications. See timeline
in Figure 1.
The follow-up for her sarcoma involved annual radiological controls,
which were systematically discussed in a tumour board with close
collaboration among radiologists, nephrologists, oncologists, and
surgeons. A PET-CT 18F-FDG scan, requested to rule out a neoplastic
lesion, revealed a 6 cm right internal pararenal lesion and a 6.2 cm
left internal pararenal lesion with a necrotic centre. The investigation
was complemented by magnetic resonance imaging, which showed nothing
suspicious and stable lesions on both sides. (Figure 2)
Antihypertensive therapy was intensified following the pre-anaesthetic
outpatient consultation a week before admission. Dialysis was performed
the day before surgery. See preoperative biological parameters in Table
1.