CARCINOMA DE CÉLULAS RENAIS T1a TRATADO COM NEFRECTOMIA RADICAL: IMPLICAÇÕES FUNCIONAIS E ONCOLÓGICAS EM PACIENTE IDOSA.

Abstract

Renal cell carcinoma (RCC) is the most common primary malignant kidney tumor in adults and is increasingly diagnosed at early stages due to the widespread use of imaging techniques. For tumors classified as T1a (≤4 cm), partial nephrectomy is considered the standard treatment, as it provides oncological outcomes equivalent to radical nephrectomy while preserving renal function. However, radical nephrectomy is still performed in selected clinical scenarios. This study aims to report a case of T1a RCC treated with radical nephrectomy in an elderly patient and to discuss its functional and oncological implications. This is a retrospective case report based on clinical, laboratory, imaging, and pathological data obtained from medical records. A 75-year-old female patient presented with right lumbar pain, and computed tomography revealed a 3.8 cm solid renal mass. After preoperative evaluation, she underwent right radical nephrectomy without complications. Histopathological analysis confirmed low-grade clear cell renal cell carcinoma, staged as pT1a, without aggressive features. During follow-up, a small contralateral renal nodule was identified without definitive signs of malignancy, and conservative management was adopted. Although the oncological outcome was favorable, this case raises concerns regarding the extent of surgical treatment, particularly in elderly patients, in whom renal function preservation is crucial. Therapeutic decisions in T1a RCC should be individualized, prioritizing nephron-sparing approaches whenever feasible.