Partial open tumorectomy for a renal tumor in a horseshoe kidney with a close contact with the vena cava: A case report

Saadi, Mohamed Hafedh; Chakroun, Marouene; Saadi, Ahmed; Derouiche, Amine; Ayed, Haroun; Chebil, Mohamed

INTRODUCTION AND IMPORTANCE: Horseshoe kidney has unique anatomical features, such as a complex blood supply. We report a patient with renal tumor in a horseshoe kidney in close contact with the vena cava, who underwent open tumorectomy. CASE PRESENTATION: A 72-year-old woman was referred to our hospital with a 4-cm enhancing mid-pole mass in the right moiety of a horseshoe kidney. Open tumorectomy was performed with parenchymal clamping. The warm ischemia time was 18 min. Pathologic examination confirmed a diagnosis of pT1a clear cell renal cell carcinoma with negative surgical margins. At 3 months postoperatively, computed tomography showed no local recurrence or metastasis and renal function was intact. CLINICAL DISCUSSION: Horseshoe kidney is a rare congenital abnormality. Renal cell carcinoma is the most frequent tumor in adults having this anomaly and treatment in localised tumors if usually tumorectomy. Surgery may be challenging in some cases because of its difficulty. CONCLUSION: Open surgery remains the standard treatment for horseshoe kidney tumors because of anatomic complexity and especially in cases where the tumor is difficult to extirpate.