2025, Volume 18, Issue 4, pp 393 – 396

Repeat robotic nephron-sparing surgery for metachronous multifocal tumors in a solitary kidney: a case report

SCImago Journal & Country Rank

Issues

Special Issues

Authors and Affiliations

Corresponding author Nicolae Bacalbasa, Department of Visceral Surgery, Center of Excellence in Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania; Department of Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Department of Visceral Surgery, Center of Digestive Diseases and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania. E-mail: nicolaebacalbasa@gmail.com

Abstract

We report the case of a 58-year-old male with metachronous renal tumors and a solitary kidney who had previously undergone an open right radical nephrectomy with extended lymphadenectomy for an invasive renal cell carcinoma (RCC) (pT3a N0M0) in November 2013. In May 2022, during routine surveillance, a left lower pole lesion measuring 2.5 × 2 × 1.6 cm was detected, and the patient was submitted to robot-assisted partial nephrectomy (RAPN). The histopathological study confirmed the presence of a pT1a Fuhrman grade 3 clear cell renal carcinoma. In October 2024, follow-up imaging revealed a new upper pole lesion measuring 4 × 3 × 2.3 cm in the left kidney. The patient was submitted to a novel robot-assisted partial nephrectomy, which was successfully completed using selective clamping of the renal artery. The clamping time was 28 minutes (versus 17 minutes during the initial procedure), and the estimated blood loss increased to approximately 300 mL compared to about 100 mL previously, with a console time of 98 minutes. The patient was discharged after the second surgery in good functional status. The final pathology revealed clear cell RCC, Fuhrman grade 2/nucleolar grade 2 (WHO/ISUP 2016), and pT1a, with negative margins. Despite increased technical challenges during reoperation, postoperative renal function remained stable, underscoring the feasibility of repeat RAPN in a solitary kidney.

Keywords

About this article

PMC ID: 12094315
PubMed ID: 
DOI: 10.25122/jml-2025-0059

Article Publishing Date (print): 4 2025
Available Online: 

Journal information

ISSN Printing: 1844-122X
ISSN Online: 1844-3117
Journal Title: Journal of Medicine and Life

Copyright License: Open Access

This article is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use and redistribution provided that the original author and source are credited.


SCImago Journal & Country Rank

Issues

Special Issues