Clinical case:

A 77-year-old woman had clinical symptom onset with pain in the left flank of 20-day progression and bone pain. An ultrasound study identified a mass that was dependent on the upper pole of the left kidney. A non-contrast-enhanced tomography scan, complemented with a magnetic resonance study, revealed a solid lesion with central necrosis that extended into the renal sinus (T2a; GII). Treatment was laparoscopic left radical nephrectomy. The diagnosis was Bellini duct carcinoma. A new 16-mm left lateroaortic lymph node was found at the follow-up at 5 months. The lesion was excised, and retroperitoneal lymph node dissection was carried out, producing 20 lymph nodes with lymphoid hyperplasia that were negative for malignancy. Thirty-nine months after the nephrectomy, a computed tomography scan identified a retroperitoneal paraaortic tumor and an intercaval-aortic retroperitoneal tumor, consistent with disease recurrence. Metastasectomy was performed and the histopathologic report described a solid, irregular, greyish-white tumor that had extensive areas with blood in the left lower portion and a moderate amount of necrotic foci. At present, after 42 months of follow-up, the patient is under surveillance and has no signs of recurrence.

Conclusions:

Collecting duct carcinoma is a rare neoplasia. The case reported herein has the longest survival period and recurrence time for symptomatic T2M0 disease: 39 months.

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