Nam did not undergo regular health check-ups, so he was surprised by the diagnosis. "I thought it was kidney stones causing fluid retention and pain, never imagining it was a large tumor," he said.

Master of Science, Doctor Cao Vinh Duy, from the Urology Department, Center for Urology - Nephrology - Andrology, Tam Anh General Hospital TP HCM, stated that ruptured kidney tumors are a serious complication of various kidney tumors, most commonly angiomyolipomas. Ruptured kidney cancer, like Nam's case, is less frequently reported.

Large kidney tumors or those with internal necrosis are prone to rupture, and some tumors may rupture after trauma. A ruptured tumor often causes severe flank pain, hematuria, fever, and can be life-threatening due to internal abdominal bleeding. Emergency surgical intervention, such as embolization to stop bleeding, tumor removal surgery, or nephrectomy, is required after hemodynamic stability is achieved.

Nam's 8 cm tumor in the right kidney was bleeding. *Photo: Tam Anh General Hospital*

For one week, Nam received medical treatment from doctors to control the tumor and prevent further bleeding. Once the bleeding was controlled, Doctor of Science, Doctor Le Phuc Lien, Head of the Female Urology Unit, along with Doctor Duy and the surgical team, operated to remove Nam's kidney tumor.

Due to the tumor's size, kidney-sparing surgery was not possible. The doctors decided on a laparoscopic right nephrectomy, removing the ruptured kidney tumor and completely dissecting the hematoma around the kidney, to avoid the risk of cancer cell spread if it were malignant. The specimen removed from the patient's body was sent for pathological analysis, and one week later, the results confirmed clear cell renal cell carcinoma (ccRCC), stage T2a.

Doctor Lien and Doctor Duy performed laparoscopic surgery on Nam. *Photo: Tam Anh General Hospital*

Globally, over 430,000 new kidney cancer cases are recorded, with Vietnam accounting for more than 2,200 cases, according to Globocan 2022. In adults, clear cell renal cell carcinoma is the most common type of kidney cancer, making up about 80% of renal cell carcinoma cases. The main cause of the disease is not clearly identified, but risk factors include obesity, smoking, and exposure to harmful chemicals. Nam, for example, smoked for nearly 20 years and consumed alcohol, which are risk factors for kidney cancer.

Doctors advise regular health check-ups, especially abdominal and kidney ultrasounds, for early detection of kidney tumors. It is also important to avoid risk factors such as not smoking, limiting alcohol consumption, avoiding toxic environments, and maintaining a healthy weight.

Ha Thanh

*Patient's name has been changed