Kauvery Hospital Vadapalani treats Rare Kidney and Bladder Tumor Case with Minimally Invasive Surgery

The patient, an 85-year-old male with a longstanding history of diabetes, was referred to Kauvery Hospital after presenting with hematuria (blood in the urine) and an abnormal located kidney identified in an ultrasound performed at another hospital. The initial diagnosis suspected an infection in the right kidney, but further investigation revealed a far more complex condition.

At Kauvery Hospital, a comprehensive series of diagnostic tests were carried out, including advanced imaging and endoscopy. These revealed not only a bladder tumor but also a tumor in an ectopic pelvic kidney – a kidney located abnormally in the lower abdomen rather than the upper abdomen where the kidney is usually situated. This discovery led to the diagnosis of a of urothelial carcinoma both in the kidney and bladder  , a cancer that originates in the lining of the urinary tract, both in the kidney and bladder.

"This is an extraordinarily rare condition," said Dr. Aarthy P., Consultant Urologist and Robotic Surgeon. "To find urothelial tumor inside ectopic kidney at the same time is something we rarely encounter in clinical practice. The condition had only been reported in a handful of cases worldwide, and in India, there have been only 3-4 such instances.”

Given the complexity of the case, the team opted for a minimally invasive approach to surgery, aiming to reduce the patient’s post-operative pain, speed up recovery, and ensure the best possible outcomes. The team performed a Endoscopy Removal of Bladder tumor (TURBT) laparoscopic right nephrouretercetomy (removal of the kidney & Ureter ) with lymph node dissection, using only three small incisions of approximately 1 cm each. This technique, known as laparoscopic surgery, avoids large incisions and muscle cutting, significantly reducing the trauma to the body.

This laparoscopic approach allowed us to remove the kidney and the tumor with minimal disruption to the surrounding tissue. The patient’s recovery was swift and remarkably comfortable. He experienced very little pain post-surgery and was able to return to his daily activities sooner than we expected. In addition to the nephrectomy, the patient also received intravesical therapy, a treatment where medication is administered directly into the bladder, to prevent the recurrence of the bladder tumor. The surgical procedure and subsequent treatments were carried out with the utmost precision, with the aim of offering the best chance for long-term survival.

Following the surgery, the patient experienced a smooth recovery, although his pre-existing diabetes led to some complications in the form of diabetic ketoacidosis (DKA), a serious condition that can develop in people with uncontrolled diabetes. However, with the swift intervention of the medical team, the patient’s DKA was successfully managed, and he made a full recovery.

Postoperative pathology confirmed that the tumors were high-grade, indicating a more aggressive form of cancer. As a result, the patient will require chemotherapy in the near future to reduce the risk of recurrence and improve his long-term prognosis.

Dr. Aravindan Selvaraj, Co-Founder & Executive Director  Kauvery Group of Hospitals said, “This is one of the rarest cases we have encountered, and performing such a surgery with minimally invasive techniques is a significant achievement. There are only 3-4 reported cases of this condition in India, and the surgical approach we used has been proven to be highly effective. The patient is doing well post-surgery and is expected to continue his recovery under our careful supervision. Cases like these challenge us as medical professionals to constantly innovate and adapt. The techniques and insights gained from this procedure will help improve the care of future patients with similar conditions."

Kauvery Hospital, Vadapalani, has long been known for its state-of-the-art medical facilities and commitment to providing the highest standard of care. The hospital's urology department, led by a team of highly skilled surgeons, offers specialized treatments for a range of complex urological conditions, including cancers of the kidney, bladder, and prostate.