A Case of ACD-Associated RCC with Lymph Node Metastasis and Contralateral Renal Carcinoma after Nephrectomy

A 59-year-old man who had undergone hemodialysis for 13 years was diagnosed with left renal cell carcinoma (RCC), cT1aN0M0, in 2010. He had a laparoscopic left nephrectomy, and the pathological diagnosis at that time was clear cell carcinoma, pT1a (multifocal). At 1 year after surgery, he was diagnosed with a left renal hilar lymph node metastasis and a new right RCC, cT1aN0M0. Consequently, he underwent a right nephrectomy and retroperitoneal lymph node dissection in 2012. Pathologic diagnosis by the current classification of the right renal tumor was acquired cystic disease-associated renal cell carcinoma (ACD-associated RCC), and that of the left hilar lymph node was metastatic RCC with sarcomatoid change. According to the revised classification the pathological diagnosis of the left renal tumor was ACD-associated RCC. There has been no evidence of recurrence or metastasis for 3 years after the second operation. The specific classification of dialysis-related renal tumors and their characteristics should be standard knowledge for urologists