PARTIAL NEPHRECTOMY OF A HORSESHOE KIDNEY WITH RENAL-CELL CARCINOMA AND CHOLECYSTECTOMY: A CASE REPORT

Abstract

Aims: Horseshoe kidneys are the most common type of renal fusion anomaly and it may be associated with other anomalies and complications. Our case aims to present the partial nephrectomy of a horseshoe kidney with renal-cell carcinoma and cholecystectomy. Case Report: A sixty-year-old male patient was admitted to our outpatient clinic with a 3 cm suspicious mass in the horseshoe kidney that was detected during an attack of acute cholecystitis. Computed tomography revealed a heteroge- neous hypodense lesion containing millimetric calcific foci of 35x31x33 mm in size at the ventral middle part of the right kid- ney. Partial nephrectomy was performed non-ischemically and then cholecystectomy was performed. Pathological examination revealed stage T1a clear cell renal carcinoma, WHO/ISUP Grade 2 with a negative surgical margin. During follow-up; urea, creatinine, and glomerular filtration rate were found to be normal. Conclusion: Horseshoe kidneys are fairly common among renal anomalies. Cholecystectomy following non-ischemic partial nephrectomy for a tumor in the horseshoe kidney is a rare case.

Keywords

• Horseshoe kidney
• nephrectomy
• cholecystectomy

References

1. 1. Schiappacasse G, Aguirre J, Soffia P et al. CT findings of the main pathological conditions associated with horseshoe kidneys. Br J Ra- diol 2015;88(1045):20140456.
2. 2. Kirkpatrick JJ, Leslie SW. Horseshoe Kidney. [Updated 2020 Aug 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Pub- lishing; 2020 Jan-. Available from: URL: https://www.ncbi.nlm.nih. gov/books/NBK431105/.
3. 3. Natsis K, Piagkou M, Skotsimara A et al. Horseshoe kidney: a re- view of anatomy and pathology. Surg Radiol Anat 2014;36(6):517– 26.
4. 4. Glenn JF. Analysis of 51 patients with horseshoe kidney. N Engl Med 1959;261:684–7.
5. 5. Mesrobian HJ, Kelalis PP, Hrabovsky E et al. Wilms tumor in horseshoe kidneys: a report from the National Wilms Tumor Study. J Urol 1985;133:1002-3.
6. 6. Bhandarkar KP, Kittur DH, Patil SV et al. Horseshoe kidney and associated anomalies: single institutional review of 20 cases. Afr J Paediatr Surg 2018;15(2):104-7.
7. 7. Şeker KG, Şam E, Şahin S et al. Partial nephrectomy in horse- shoe kidney: primary carcinoid tumor. Arch Ital Urol Androl 2017;89(4):316-8.
8. 8. Tkocz M, Kupajski M. Tumour in horseshoe kidney - different surgical treatment shown in five example cases. Contemp Oncol 2012;16(3):254-7.

9. 9. Hohenfellner M, Schultz-Lampel D, Lampel A et al. Tumor in horseshoe kidney: clinical implications and review of embryogene- sis. J Urol 1992;147:1098–102.
10. 10. Rubio Briones J, Regalado Pareja R, Martin FS et al. Incidence of tumoural pathology horseshoe kidneys. Eur Urol 1998;33:175–9. 11. Justo-Janeiro JM, Orozco EP, Reyes FJ et al. Transplantation of a horseshoe kidney from a living donor: case report, long term out- come and donor safety. Int J Surg Case Rep 2015;15:21-5.