Value of preoperative superselective embolization of the isthmus in a patient with upper urinary tract urothelial carcinoma and horseshoe kidney.
Standard treatment for upper urinary tract urothelial carcinoma (UUTUC) implies the radical removal of all urothelium-lined tissue, which requires nephroureterectomy with bladder cuff removal. We report on a patient with a rare coincidence of UUTUC and horseshoe kidney in whom a preoperative angiography helped to identify and subsequently embolize an abberant isthmic feeding artery, which was located in between both collecting systems. Ischemic discoloration of the isthmus area facilitated resection and no major blood loss occurred. Preoperative superselective embolization of the isthmus as the renal split area can be an effective tool to facilitate nephroureterectomy in the case of a horseshoe kidney.
Wilhelmsen
Skadi
S
Department of Radiology and Nuclear Medicine, Otto-von-Guericke University, Leipziger Strasse 44, 39120 Magdeburg, Germany.
Janitzky
Andreas
A
Porsch
Markus
M
Liehr
Uwe-Bernd
UB
Dudeck
Oliver
O
D001027:Aortography; D002295:Carcinoma, Transitional Cell / Q000098:blood supply* / Q000175:diagnosis / Q000601:surgery*; D004621:Embolization, Therapeutic; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007668:Kidney / Q000002:abnormalities*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000098:blood supply* / Q000175:diagnosis / Q000601:surgery*; D009392:Nephrectomy; D011183:Postoperative Complications / Q000175:diagnosis; D011300:Preoperative Care; D012077:Renal Artery / Q000002:abnormalities*; D036542:Tomography, Spiral Computed; D014513:Ureter / Q000601:surgery; D014516:Ureteral Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000601:surgery*; D014567:Urography