Hemi-nephrectomy for renal malignancy in patients with horseshoe kidney : A case report

Abstract

Author(s): Arber Neziri, Luljeta Neziri-Ahmetaj*, Avni Fetahu, Ferdinand Komani, Sabit Mehmeti and Musa Oruqi

Introduction: Horse Shoe kidney (HSK) is the most common fusion anomaly, with an incidence rate of 1 in 400 of the general population. While most of the reported cases are incidental findings, sometimes a patient may present with pictures of hydronephrosis, infection, and calculus formation. In these patients, nephron-sparing surgical management of renal tumour s may be complicated by abnormal renal location, aberrant vasculature, and the presence of a renal isthmus.

Case Report: Forty six-old male patient was admitted to our outpatient clinic with a 10 cm suspicious mass in the horseshoe kidney that was detected during an attack of acute abdominal pain and haematuria. Computed tomography revealed a heterogeneous hypodense lesion containing renal tumour of 100 mm x 100 mm x 85 mm in size in upper pole at left kidney. Partial nephrectomy was performed non-ischemically Pathological examination revealed stage carcinoma urothelialis high grade with a negative surgical margin. During follow-up; urea, creatinine, and glomerular filtration rate were found to be normal.

Conclusion: The incidence of renal cell carcinoma in horseshoe kidneys is the same as in normal kidneys, and its development and course are not associated with the presence of the defect. According to the literature, transitional cell carcinoma is more common in horseshoe kidneys. This may be due to the presence of defects such as urinary obstruction, affiliation for nephrolithiasis, and chronic infection.

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