Khayyamfar Feraidoon, Dalil Davood, Khayyamfar Amirmahdi
Department of Urology Mostafa Khomeini Hospital, Shahed University Tehran Iran.
Student Research Committee, Faculty of Medicine Shahed University Tehran Iran.
Clin Case Rep. 2023 Oct 29;11(11):e8116. doi: 10.1002/ccr3.8116. eCollection 2023 Nov.
Although anatomical and vascular abnormalities of the horseshoe kidney might be challenging, complete preoperative imaging evaluations and accurate organ-sparing surgical planning can lead to much lower complications.
Horseshoe kidney (HK) is one of the most common renal fusion anomalies. Renal carcinoids are rarely reported in HK patients. Here, we described a rare case of advanced right renal cell carcinoma (RCC) along with proximal left ureter stone in a 41-year-old man who presented with a complaint of turbid urine. Early blood tests revealed a blood urea nitrogen of 44 mg/dL and serum creatinine of 1.35 mg/dL. The urine analysis showed microscopic hematuria (6-8 RBCs) and few calcium oxalate crystals. The imaging evaluations revealed an HK anomaly with a solid mass on the right side and a 4 mm stone in the proximal left ureter. The findings suggested RCC which was confirmed by histopathology examination. Consequently, the patient was scheduled for an organ-preserving open surgery of a right kidney tumor with concomitant left ureterolithotomy. The 16-month follow-up showed no urological complications, metastasis, or tumor proliferation. Although the anatomical and vascular abnormalities of HK might be challenging, organ-sparing surgical treatment should be considered in feasibly resectable tumors. Complete preoperative imaging evaluations to identify the characteristics of HK, as well as accurate surgical planning, can lead to much lower complications.
尽管马蹄肾的解剖和血管异常可能具有挑战性，但完整的术前影像学评估和精确的保留器官手术规划可使并发症大大减少。
马蹄肾（HK）是最常见的肾脏融合异常之一。HK患者中肾类癌很少见。在此，我们描述了一例罕见病例，一名41岁男性患有晚期右肾细胞癌（RCC）并伴有左输尿管上段结石，主诉尿液浑浊。早期血液检查显示血尿素氮为44mg/dL，血清肌酐为1.35mg/dL。尿液分析显示镜下血尿（6 - 8个红细胞）和少量草酸钙结晶。影像学评估显示存在HK异常，右侧有一个实性肿块，左输尿管上段有一个4mm的结石。这些发现提示为RCC，经组织病理学检查证实。因此，该患者计划接受保留器官的右肾肿瘤开放手术并同时进行左输尿管切开取石术。16个月的随访显示无泌尿系统并发症、转移或肿瘤增殖。尽管HK的解剖和血管异常可能具有挑战性，但对于可切除的肿瘤应考虑保留器官的手术治疗。完整的术前影像学评估以确定HK的特征以及精确的手术规划可使并发症大大减少。
