Off- Clamp nephron sparing minimally invasive surgery for multifocal tumors: experience of a case

Abstract

Description of the clinical case: 61-year-old female who presented to the outpatient clinic, asymptomatic and with an imaging study suggestive of multiple ipsilateral right kidney tumors as well as adrenal incidentaloma. The patient was treated with a laparoscopic partial nephrectomy of both renal tumors and adrenalectomy. Renal cell cancer nuclear grade 2 has been reported in the tumor of the upper pole, angiomyolipoma in the middle region of the kidney and cortical adenoma.

Relevance: Until now, the incidence of synchronous renal tumors at the time of diagnosis is unknown, likewise with new technologies and with greater surgeon’s experience, nephron-preserving surgery has been proposed in multifocal renal tumors for the treatment of this type of tumors.

Clinical implications: There is a controversy and few reports where this type of tumors are treated with nephron-sparing surgery in multifocal tumors. So far in series of clinical cases this technique has been reported as safe and feasible in selected cases.

Conclusions: In expert hands and in particular cases, this technique seems to be a reproducible and safe procedure for the patient, thus ensuring that part of the renal unit is preserved, and good oncological results.