A Neoplastic differentiation consists of clustered spindle cells adjacent to
renal capsule.
Interestingly, one case has been reported which showed an intra renal growth pattern without connection to the
renal capsule or renal pelvis.
At end of the procedure before extubation under fluoroscopy guidance, the respective drug was infiltrated in all the three groups (B, R, & S groups) with a 23-gauge spinal needle (10cm length) along the nephrostomy tube at 3 o'clock and 9 o'clock positions (10mL in each tract) including
renal capsule, muscles, subcutaneous tissue, and skin.
3) The
renal capsule is the most common site of origin of genitourinary leiomyomas.
The entire perirenal fatty tissue is removed to the level of Gerota fascia, a membranous structure that is similar to the consistency of the
renal capsule that encases the kidney in perirenal fat.
DISCUSSION: Spontaneous nontraumatic bleeding confined to the subcapsular and/or perinephric space in patients with no known underlying cause was first described as "spontaneous
renal capsule apoplexy" by Carl Reinhold August Wunderlich in 1856 (2,4).
They also stated that, pT1 tumors infiltrating
renal capsule are significantly larger than the ones those do not, although the same correlation between tumor size and capsular involvement could not be demonstrated for pT2 patients and the entire cohort.
The
renal capsule, ureter, renal veins, and adrenal gland were free of tumor.
On gross inspection, the tumour at the lower pole of left kidney measured 8 x 6 cm and the hematoma was subjacent to the
renal capsule.
TABLE 2: Staging of Wilms' tumor STAGE DESCRIPTION % OF CASES Stage I Limited to the kidney and completely 40% resectable with
renal capsule intact Stage II Tumor infiltrates beyond kidney, 20-25% completely resected; includes tumor with local spillage confined to flank Stage III Residual tumor confined to abdomen, 20-25% includes (a) positive abdominal nodes, (b) diffuse peritoneal contamination by direct growth, implants, or spillage, (c) positive margins, or (d) residual non resected tumor Stage IV Hematogenous disease (added: lungs, 10% lymph nodes, liver) Stage V Bilateral disease; each side should be 5%
In the left kidney, a mass measuring 15 x 5 x 2 cm replaced almost all normal parenchyma and penetrated the
renal capsule.
The well-encapsulated and sharply demarcated tumor extended from the hilum to the
renal capsule, but did not breech the capsule.
