Retroperitoneoscopic single-site 3D adrenalectomy for left adrenal renal cell carcinoma metastasis 20 years after left laparotomic radical nephrectomy

Abstract

The aim of the paper is to demonstrate the practicability of retroperitoneoscopic single-site 3D left adrenalectomy after previous homolateral laparotomic renal surgery. We present a case report of a 70-year-old male who underwent radical nephrectomy in 1999. Twenty years after radical nephrectomy, the patient underwent a computed tomography scan for B-cell lymphoma follow-up, which revealed a 30 mm left adrenal mass suspicious for a delayed renal-cell carcinoma metastasis. After multidisciplinary discussion, surgery was chosen as first option. To minimize surgical morbidity as much as possible, a 3D laparoscopic single-site retroperitoneal approach was chosen. The patient had no peri- or intra-operative complications and was discharged on Postoperative Day 3. The final histological report revealed an adrenal clear cell renal-cell carcinoma metastasis. This experience shows that single-site retroperitoneal laparoscopic adrenalectomy is possible in patients who underwent previous abdominal cancer surgery and is an option to consider when determining optimal approaches for adrenal surgery.

Keywords

Adrenalectomy / laparoscopy / laparoendoscopic single-site surgery / renal cell carcinoma metastases

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