Tang JE, Wang RJ, Fang ZH, Zhu PY, Yao JX, Yang H. Treatment of fat-poor renal angiomyolipoma with ectopic blood supply by fluorescent laparoscopy: A case report and review of literature. World J Clin Oncol 2024; 15(11): 1435-1443 [PMID: 39582616 DOI: 10.5306/wjco.v15.i11.1435]
Corresponding Author of This Article
Hua Yang, Doctor, Department of Andrology, Huzhou Women and Children's Hospital, No. 2 East Street, Huzhou 313000, Zhejiang Province, China. 50173@zjhu.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jian-Er Tang, Rong-Jiang Wang, Zhi-Hai Fang, Ping-Ya Zhu, Jian-Xiang Yao, Department of Urology, First Affiliated Hospital of Huzhou Normal College, Huzhou 313000, Zhejiang Province, China
Hua Yang, Department of Andrology, Huzhou Women and Children's Hospital, Huzhou 313000, Zhejiang Province, China
Author contributions: Tang JE and Yang H contributed to the conception and design of the review; Tang JE wrote the manuscript; Fang ZH and Wang RJ validate the manuscript; Zhu PY and Yao JX contribute to the establishment of the model; All authors have read and agreed to the published version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hua Yang, Doctor, Department of Andrology, Huzhou Women and Children's Hospital, No. 2 East Street, Huzhou 313000, Zhejiang Province, China. 50173@zjhu.edu.cn
Received: June 5, 2024 Revised: September 5, 2024 Accepted: September 27, 2024 Published online: November 24, 2024 Processing time: 130 Days and 14.9 Hours
Abstract
BACKGROUND
Renal angiomyolipoma and renal cell carcinoma are the most common benign and malignant tumors of the kidney respectively, and the preoperative differential diagnosis is crucial due to the wide difference in treatment methods. Fat-poor renal angiomyolipoma is a relatively rare type of in renal angiomyolipoma. Its fat imaging features are not obvious, and it is easily misdiagnosed as renal cell carcinoma.
CASE SUMMARY
We report the case of a 41-year-old man who complained of osphyalgia. Subsequent abdominal computed tomography scans revealed that a heterogeneous mass was seen in the lower pole of the right kidney, with the size of about 53 mm × 47 mm. And showed two right renal arteries, with the mass supplied by an ectopic vessel from the abdominal aorta. Fluorescent laparoscopic blockade of the right renal heterotopic artery and partial nephrectomy was performed. Based on histological and immunohistochemical findings, the tumor was diagnosed as fat-poor renal angiomyolipoma.
CONCLUSION
The use of fluorescent laparoscopy can effectively help intraoperative management, and the fluorescence pattern provided by intravenous indocyanine green can help suggest the final diagnosis, effectively guide the surgical decision-making, and avoid preoperative imaging diagnosis leading to nephrectomy for benign renal tumors, through fluorescent navigation of tumor supply vessel precise block, minimize the loss of renal function.
Core Tip: We used the PINPOINT fluorescent laparoscopic system intraoperatively. The fluorescence pattern provided by intravenous indocyanine green helped to suggest the final diagnosis and effectively guided surgical decision making, avoiding nephrectomy for benign renal tumors. In the fluorescence mode, we only blocked the ectopic blood vessels supplying the tumor, thus minimizing the loss of renal function.
