Chaker Kays, Gharbia Nader, Ouanes Yassine, Zehani Alia, Mosbahi Boutheina, Nouira Yassine
Department of Urology, La Rabta Hospital, University of Tunis El Manar, Tunis, Tunisia.
Department of Urology, La Rabta Hospital, University of Tunis El Manar, Tunis, Tunisia.
Int J Surg Case Rep. 2025 Mar;128:111015. doi: 10.1016/j.ijscr.2025.111015. Epub 2025 Feb 4.
Horseshoe kidneys are often considered a typical and frequently occurring type of kidney fusion anomaly when compared to other anomalies. Surgery for tumors that appear in horseshoe kidneys can challenging due to the abnormal vasculature and the potential need for isthmectomy. In such cases, open surgery remains a viable treatment option.
A 65-year-old African male patient hospitalized for total hematuria evolving for 6 months, and right lumbar pain without fever. The patient underwent a computed tomography scan, which revealed the presence of a solid mass occupying the junction of the isthmus and the inferior pole of left renal of a horseshoe kidney wish measured 30 mm. Tumorectomy was done by open lobotomy. The histological examination of the surgical specimen showed the presence of a clear cell carcinoma of the left kidney. After 52 months of clinical and radiological check-up, there was no functional complaint or any sign of recurrence.
Horseshoe kidneys are the most common fusion anomaly. These patients have an increased risk of malignant tumors, including renal cell carcinoma. Many studies indicate that horseshoe kidney tumors can be treated with partial nephrectomy, if feasible, with generally acceptable morbidity.
This report presents a successful case where open surgery was used to partially remove a horseshoe kidney affected by renal carcinoma. We believe that, in certain circumstances, such as the presence of complex vascularization or an unfavorably located tumor, open surgery remains a reliable option for nephron-sparing procedures.
与其他肾脏异常相比，马蹄肾通常被认为是一种典型且常见的肾脏融合异常类型。由于马蹄肾血管异常以及可能需要进行峡部切除术，对马蹄肾中出现的肿瘤进行手术具有挑战性。在这种情况下，开放手术仍然是一种可行的治疗选择。
一名65岁的非洲男性患者因持续6个月的全程血尿和右侧腰痛入院，无发热症状。患者接受了计算机断层扫描，结果显示在马蹄肾左肾峡部与下极交界处有一个实性肿块，大小为30毫米。通过开放性肾叶切除术进行了肿瘤切除。手术标本的组织学检查显示为左肾透明细胞癌。经过52个月的临床和影像学检查，患者无功能方面的不适，也没有复发迹象。
马蹄肾是最常见的融合异常。这些患者患恶性肿瘤（包括肾细胞癌）的风险增加。许多研究表明，如果可行，马蹄肾肿瘤可以通过部分肾切除术进行治疗，总体发病率可接受。
本报告展示了一例成功的病例，即通过开放手术部分切除了患有肾癌的马蹄肾。我们认为，在某些情况下，如存在复杂血管情况或肿瘤位置不佳时，开放手术仍然是保留肾单位手术的可靠选择。
