A Case of Pediatric Renal Cell Carcinoma With TFE3 Rearrangement Treated With Robot-Assisted Partial Nephrectomy

Area of Science:

• Pediatric Oncology
• Surgical Oncology
• Urologic Oncology

Background:

• Renal cell carcinoma (RCC) is rare in children, with TFE3-rearranged RCC (tRCC) being a specific subtype.
• Robot-assisted partial nephrectomy (RAPN) is standard for adult RCC but less common in pediatric cases.

Observation:

• An 11-year-old boy presented with a growing cystic renal mass.
• Contrast-enhanced CT identified a solid, enhancing component.
• The patient underwent successful RAPN using the da Vinci Xi system without complications.

Findings:

• Histopathology confirmed tRCC via morphology and immunohistochemistry, despite a negative TFE3 split FISH test.
• The patient recovered well and was discharged on postoperative day 6.
• No recurrence was observed at the 24-month follow-up.

Implications:

• This case demonstrates the feasibility and effectiveness of RAPN for pediatric RCC.
• Nephron-sparing surgery, like RAPN, can be a viable option for select pediatric oncology patients.
• Careful patient selection and surgical planning are crucial for successful outcomes in pediatric RAPN for tRCC.