# A Case of Bilateral Renal Cancer in a Dialysis Patient With Enlarged ACDK Treated With Staged Laparoscopic Nephrectomy

## TL;DR

A dialysis patient with very large kidney tumors successfully underwent laparoscopic surgery to remove both kidneys without complications.

## Contribution

Demonstrates the feasibility of laparoscopic nephrectomy for extremely enlarged ACDK kidneys in ESRD patients.

## Key findings

- Staged laparoscopic nephrectomy was successfully performed for bilateral ACD-RCC with kidneys over 1200 g each.
- No conversion to open surgery, transfusion, or major complications occurred despite extreme kidney size.
- Laparoscopic radical nephrectomy is viable for large ACDK kidneys with meticulous planning.

## Abstract

End‐stage renal disease (ESRD) patients have a high risk of Acquired Cystic Disease‐associated Renal Cell Carcinoma (ACD‐RCC) due to chronic inflammation and cystic renal atrophy. Although laparoscopic radical nephrectomy (LRN) is standard, massively enlarged kidneys may increase surgical difficulty.

We describe a long‐term dialysis patient with bilateral ACD‐RCC. Each kidney weighed over 1200 g. Despite the extreme size and cystic architecture, LRN was completed without conversion, transfusion, or major postoperative complications.

This case demonstrates that LRN can be safely and effectively performed in ESRD patients even when ACD‐RCC involves unusually large kidneys.

We report a case of bilateral ACD‐RCC successfully managed with staged LRN. Despite extreme kidney enlargement exceeding 1200 g on each side, both procedures were completed laparoscopically without conversion or major complications. This case demonstrates that LRN can be safely performed even in massively enlarged Acquired Cystic Disease of the Kidney (ACDK) kidneys when careful surgical planning is applied.