Robotic Partial Nephrectomy for the Treatment of Renal Cell Carcinoma in Horseshoe Kidneys: First Case Report and Literature Review

Horseshoe kidneys are common congenital renal malformations. Affected patients will have fusion of the lower poles of both kidneys. This condition is usually associated with aberrant renal vessels and ureteropelvic junction obstruction. The procedures needed for treatment of associated conditions in horseshoe kidneys are challenging. Renal cell carcinoma in horseshoe kidneys is not a common condition. For clinical T1 tumors, partial nephrectomy should be considered as the first treatment option, as in a normal kidney patient. We report our first experience of a robotic partial nephrectomy of renal cell carcinoma in a horseshoe kidney patient. A 48-year-old man presented with nonspecific abdominal pain, and the abdominal imaging revealed horseshoe kidneys with a solid, enhancing renal mass of 43x37 mm at the upper pole of the right kidney. A robotic partial nephrectomy was successfully performed without perioperative complications. Kidney function remained the same. Robotic partial nephrectomy in horseshoe kidneys is technically safe and feasible and is able to achieve trifecta for a partial nephrectomy. Our surgical techniques and the literatures on this topic are discussed within.