Korean J Radiol.  2005 Sep;6(3):200-203. 10.3348/kjr.2005.6.3.200.

Renal Cell Carcinoma in a Horseshoe Kidney and Preoperative Superselective Renal Artery Embolization: A Case Report

• Kim TH

• KMID: 1102718
• DOI: http://doi.org/10.3348/kjr.2005.6.3.200

Abstract

Only rarely is renal cell carcinoma encountered in a horseshoe kidney. This is a case report on renal cell carcinoma in a horseshoe kidney, in which superselective renal artery embolization was performed preoperatively. CT and digital subtraction angiography revealed a horseshoe kidney with a 3-cm tumor in the left side. Superselective renal artery embolization of the tumor was performed as a prerequisite procedure for the organ-preserving surgery of simple enucleation. Preoperative superselective renal artery embolization can be an effective tool to facilitate organ-preserving surgery in a horseshoe kidney.

Keyword

Kidney abnormalities; Interventional procedure

MeSH Terms

*Renal Artery
Middle Aged
Male
Kidney Neoplasms/complications/*therapy
Kidney/*abnormalities
Humans
*Embolization, Therapeutic
Carcinoma, Renal Cell/complications/*therapy
Abnormalities/therapy

Figure

• 

  Fig. 1 A 59-year-old man with renal cell carcinoma in a horseshoe kidney. A. Preoperative CT scan reveals a horseshoe kidney with a well enhanced isthmus (white arrows) and a 3-cm enhancing mass (black arrows) close to the collecting system in the left part. B. Digital subtraction angiography of the aorta at the level of the isthmus shows the isthmus was fed by a three-vessel supply that consisted of two aberrant vessels (arrows) originating from the aorta, which entered both sides of isthmus, and an additional vessel to the medial portion of the left side of the isthmus that originated from the left common iliac artery (curved arrow). C. Digital subtraction angiography of the left renal artery demonstrates hypervascular tumor staining (arrows) that was supplied by the anterior inferior segmental branch of the left main renal artery. The tumor feeding vessel was superselectively catheterized with the use of a 3-F microcatheter, and then it was embolized with Contour and a microcoil. D. Postembolization angiography shows successful segmental embolization of the anterior inferior segment of the left kidney, including the tumor. E. Gross specimen shows a well-circumscribed, bright yellow mass (arrows) that measured about 3 cm. F. Microscopically, the tumor was a typical clear cell carcinoma showing abundant clear cytoplasm, bland nuclei and small inconspicuous nucleoli (H & E stain, ×300). G. A follow-up CT scan 33 days after surgery shows the parenchymal defect (arrow) at the previous tumor site with postoperative changes.

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