title: Organ-Preserving Surgical Treatment of a Horseshoe Kidney Occupied by a Large Renal Cell Carcinoma with Extensive Venous Invasion: A Case Report.
abstract: The horseshoe kidney is one of the most common congenital disorders affecting the urogenital system. Following a fusion of the lower kidney poles, which in turn lead to the formation of an isthmus, this anatomical variation is accompanied by other characteristic properties like an incomplete ascension, ventral rotation of the pelvices as well as atypical vascular supply. Even though renal carcinoids and Wilms tumors are more common in horseshoe kidneys, the incidence of renal cell carcinomas seems to be unaffected. Here we report the case of a locally advanced renal cell carcinoma with extensive venous invasion occurring in a horseshoe kidney and its complex surgical management. The whole primary tumor as well as a majority of venous tumor thrombi could be removed by a combination of 2/3 nephrectomy and cavotomy with thrombectomy. During 1 year of follow-up, the patient neither suffered from a tumor relapse, nor did he require renal replacement therapy. Thus, we conclude that even in cases of RCC where advanced disease is associated with complex anatomical situations, organ-preserving surgical treatment should be pursued to achieve excellent functional and oncological results.
authors: Department of Urology, Saarland University Medical Center, Homburg/Saar, Germany.
authors: Johannes
authors: J
authors: Linxweiler
authors: Roushanak
authors: R
authors: Shayesteh-Kheslat
authors: Peter
authors: P
authors: Fries
authors: Günther
authors: G
authors: Schneider
authors: Martin
authors: M
authors: Janssen
authors: Carsten H
authors: CH
authors: Ohlmann
authors: Michael
authors: M
authors: Stöckle
authors: Stefan
authors: S
authors: Siemer
authors: Matthias
authors: M
authors: Saar
mesh_terms: D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000069337:Fused Kidney / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009392:Nephrectomy; D059351:Organ Sparing Treatments; D012082:Renal Veins / Q000473:pathology / Q000601:surgery*; D017131:Thrombectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Horseshoe kidney; Organ preservation; Renal cell carcinoma; Venous tumor thrombus