Robot-assisted left-side partial nephrectomy with a segmental resection of left lower ureter and Boari reconstruction

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Resumo

Renal cell carcinoma (RCC) accounts for more than 90% of cases of malignant kidney tumors and represents 2-3% of all malignancies worldwide. Clear cell renal cell carcinoma (ccRCC), the most common type of RCC, comprising 70–80% of cases. RCC most commonly metastasizes to the lungs, bones, lymph nodes, liver, adrenal glands, and brain. Synchronous metastasis of RCC to the ipsilateral ureter represents an extremely rare event. Ureteral metastasis is a significant diagnostic challenge, since it is quite difficult to determine whether it has metastatic origin (RCC) or it is a primary urothelial tumor. Moreover, due to the rarity of disease, treatment strategy is not well established.

We present a rare case of patient with the RCC of a single left kidney and metachronous metastasis to the ipsilateral ureter that was initially assumed to be primary urothelial carcinoma. The robotic-assisted left-side partial nephrectomy with a segmental resection of left lower ureter and Boari reconstruction was performed.

This case of successful treatment with robotic-assisted approach shows a great organ-sparing potential of robotic surgery in the treatment of complex oncological patients for whom it is extremely important to preserve the maximum volume of functioning renal tissue, particularly in those with a metastatic RCC of a single kidney.

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Sobre autores

A. Kurbanov

Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Autor responsável pela correspondência
Email: asadulla10@mail.ru

Ph.D. student at the Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Rússia, Moscow

S. Kryukov

Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Email: s.krukov78@gmail.com

6-year student, FGAOU VO I.M. Sechenov First Moscow State Medical University

Rússia, Moscow

Ya. Chernov

Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Email: yarik.chernov@mail.ru

Ph.D., urologist at the Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Rússia, Moscow

D. Chinenov

Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Email: chinenovdv@rambler.ru

Ph.D., associate professor at the Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Rússia, Moscow

A. Votyakov

Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Email: votyakov.a.yu@gmail.com

Ph.D. student at the Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Rússia, Moscow

E. Shpot

Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Email: shpot@inbox.ru

Ph.D., MD, professor at the Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Rússia, Moscow

Bibliografia

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  2. Ljungberg B., Bensalah K., Canfield S., et al. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol. 2015;67(5):913–924. doi: 10.1016/J.EURURO.2015.01.005.
  3. Bianchi M., Sun M., Jeldres C., et al. Distribution of metastatic sites in renal cell carcinoma: a population-based analysis. Ann Oncol Off J Eur Soc Med Oncol. 2012;23(4):973–980. doi: 10.1093/annonc/mdr362.
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  10. Sountoulides P., Metaxa L., Cindolo L. Atypical presentations and rare metastatic sites of renal cell carcinoma: A review of case reports. J Med Case Rep. 2011;5(1):1–9. doi: 10.1186/1752-1947-5-429/TABLES/5.
  11. Blanc J., Roth B. Clear cell renal cancer metastasis in the contralateral ureter: a case report. J Med Case Rep. 2021;15(1):1–5. doi: 10.1186/S13256-021-02839-W/FIGURES/4.
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2. Fig. 1. Multislice computed tomography (MSCT) - the arrow indicates the formations of the only left kidney (b) and the left ureter (a, c)

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3. Fig. 2. 3D modeling of a tumor of the only left kidney (a) and a tumor of the left ureter (b)

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4. Fig. 3. Macro specimen on the incision

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5. Fig. 4. Multislice computed tomography (MSCT) after removal of the catheter-stent. Urinary tract contrast

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