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  • Management conundrum in a case of renal cell cancer (RCC) on dual antiplatelet therapy (DAPT) for recently placed coronary drug-eluting stent (DES)

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Urology
Management conundrum in a case of renal cell cancer (RCC) on dual antiplatelet therapy (DAPT) for recently placed coronary drug-eluting stent (DES)
  1. Rudra Prasad Ghorai1,
  2. Sridhar Panaiyadiyan1,2,
  3. Prabhjot Singh1 and
  4. Brusabhanu Nayak1
  1. 1Department of Urology, All India Institute of Medical Sciences, New Delhi, India
  2. 2Department of Urology, National Cancer Institute - All India Institute of Medical Sciences, Jhajjar, Haryana, India
  1. Correspondence to Dr Prabhjot Singh; drprabhjotsingh{at}gmail.com

Abstract

A man in his 50s presented in an emergency with breathlessness and chest discomfort. On evaluation, he was diagnosed with coronary artery disease, with more than 80% narrowing of the right coronary and left circumflex arteries. The patient underwent percutaneous coronary intervention and was started on dual antiplatelet (DAPT) therapy. After starting DAPT, the patient developed gross haematuria with a drop in haematocrit. Further evaluation revealed a left renal mass with urinary bladder clots. Because of the risk of stent thrombosis on stopping DAPT, radical nephrectomy was deferred, and the patient underwent left renal artery angioembolisation and bladder clot evacuation. On the follow-up, the patient was stable with a gradual decrease in renal mass size, and after a year, the patient underwent definitive surgery. The patient is doing well in 4 years of follow-up with no metastasis.

  • Urology
  • Hematuria
  • Urological cancer

https://doi.org/10.1136/bcr-2023-257750

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: RPG: manuscript preparation and data collection. SP: manuscript editing and data collection. PS: manuscript editing and final approval. BN: image editing. The following authors gave final approval of the manuscript: RPG, SP, PS and BN.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.