Nephron-sparing surgery for primary mucinous adenocarcinoma of renal pelvis in horseshoe kidney: A case report.

Abstract

RATIONALE:

Mucinous adenocarcinoma of the renal pelvis is extremely rare in malignancy of the renal pelvis, and <100 cases have been reported so far. However, horseshoe kidneys appear to be more prone to this mucinous gland metaplasia. Due to the lack of a specific diagnostic basis, it is difficult to confirm the diagnosis before surgery, which is easy to cause misdiagnosis.

PATIENT CONCERNS:

We report a 64-year-old male patient who found a cystic mass in the left kidney during physical examination. CT examination showed a horseshoe kidney with a cystic mass 9.5 × 8.0 cm in front of the left kidney, lacking obvious diagnostic features.

DIAGNOSIS:

It was misdiagnosed as cystic teratoma before the operation, and was diagnosed as mucinous adenocarcinoma of the renal pelvis through pathological examination after the operation.

INTERVENTIONS:

Resection of the tumor by nephron-sparing surgery and postoperative chemotherapy.

OUTCOMES:

No tumor recurrence was found at 6 years of follow-up. After 7 years, the patient had multiple metastases in the abdominal wall and peritoneum, and no tumor recurrence was found in the urinary system. The patient received chemotherapy again and survived well.

LESSONS:

The prognosis of nephron-sparing tumor resection for MRAP is not significantly different from that of radical nephroureterectomy + bladder cuff excision. Because it can reduce the risk that patients can not tolerate follow-up chemotherapy due to abnormal renal function after surgery, which may be more beneficial in patients with kidney abnormalities or chronic disease.

• Authors: Dapeng Li, Wei Zhang, Jun Wang, An Wang, Mingming Wu, Yangguang Wei
• Journal: Medicine (Medicine (Baltimore)) Vol. 102 Issue 12 Pg. e33410 (Mar 24 2023) ISSN: 1536-5964 [Electronic] United States
• PMID: 36961136 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

Topics

• Male
• Humans
• Middle Aged
• Fused Kidney (complications, surgery, pathology)
• Kidney Neoplasms (pathology)
• Neoplasm Recurrence, Local (pathology)
• Kidney (diagnostic imaging, surgery, abnormalities)
• Kidney Pelvis (surgery, pathology)
• Nephrons (pathology)
• Adenocarcinoma, Mucinous (pathology)