Abhishek Singh, Consultant urologist at Muljibhai Patel Urological Hospital, Nadiad, shared on X:
“Although open surgery is becoming less common in uro-oncology, it remains irreplaceable when the case demands it.
A rare case of extraskeletal Ewing sarcoma of the right kidney at Muljibhai Patel Urological Hospital, Nadiad, brought that point home.
After chemotherapy, the hepatic veins remained patent, but the inferior vena cava (IVC) was obliterated from the level of the hepatic veins to below the left renal vein.
The left kidney was draining through venous collaterals. We performed a right radical nephrectomy, infrahepatic IVC excision, and interaortocaval lymph node dissection.
To provide venous outflow for the remaining kidney, we connected the left renal vein to the infrarenal IVC using a graft, as shown in the annotated intraoperative photograph.
Final histopathology reported high-grade extraskeletal Ewing sarcoma, with less than 10% viable tumour, tumour-free margins, and 0 of 31 lymph nodes involved. CD99 was negative on immunohistochemistry.
I led the urology team, and Dr. Birju Shah led the vascular surgery team.
I’m grateful to both teams for their close collaboration through the resection and reconstruction.
The accompanying flyer contains a graphic intraoperative photograph.”
Other articles about Ewing sarcoma on OncoDaily.
