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Open transperitoneal partial nephrectomy in a horseshoe kidney.

Alex Romeo1, Evan Spencer2, Jacob Baber3

  • 1Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA.

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This case study details a horseshoe kidney (HK) with a clear cell renal cell carcinoma. Surgical management involved an open partial nephrectomy due to complex aberrant vasculature.

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Area of Science:

  • Urology
  • Nephrology
  • Surgical Oncology

Background:

  • Horseshoe kidney (HK) is a congenital anomaly.
  • Renal masses in HK can present diagnostic and surgical challenges.

Observation:

  • A 50-year-old man with abdominal pain was diagnosed with HK and a right renal mass.
  • Contrast-enhanced CT scan revealed a 3.1 cm x 3.7 cm x 2.7 cm mass.
  • Renovascular angiography identified aberrant vasculature supplying the mass.

Findings:

  • Open transperitoneal right partial nephrectomy was performed due to vascular complexity.
  • Pathology confirmed a 5.0 cm Fuhrman grade II clear cell renal cell carcinoma.
  • The patient experienced a postoperative ileus, which resolved with conservative management.

Implications:

  • This case highlights the importance of detailed vascular assessment in HK renal masses.
  • Surgical planning for HK anomalies requires careful consideration of aberrant anatomy.
  • Successful oncologic resection is achievable despite complex vascular variations.