Renal Cell Carcinoma Metastasis from Biopsy Associated Hematoma Disruption during Robotic Partial Nephrectomy

We describe a case in which a patient with a past medical history of ovarian cancer received a diagnostic renal biopsy for an incidentally discovered renal mass. During left robotic partial nephrectomy (RPN), a perinephric hematoma was encountered. The hematoma was not present on preoperative imagin...

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Main Authors: Christopher Caputo, Ziho Lee, Andrew Harbin, Daniel Eun
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Urology
Online Access:http://dx.doi.org/10.1155/2014/975412
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author Christopher Caputo
Ziho Lee
Andrew Harbin
Daniel Eun
author_facet Christopher Caputo
Ziho Lee
Andrew Harbin
Daniel Eun
author_sort Christopher Caputo
collection DOAJ
description We describe a case in which a patient with a past medical history of ovarian cancer received a diagnostic renal biopsy for an incidentally discovered renal mass. During left robotic partial nephrectomy (RPN), a perinephric hematoma was encountered. The hematoma was not present on preoperative imaging and was likely a result of the renal biopsy. The renal cell carcinoma (RCC) and the associated hematoma were widely excised with negative surgical margins. On follow-up imaging at five months postoperatively, a recurrent renal mass at the surgical resection bed and several new nodules in the omentum were detected. During completion left robotic total nephrectomy and omental excision, intraoperative frozen sections confirmed metastatic RCC. We believe that a hematoma seeded with RCC formed as a result of the renal biopsy, and subsequent disruption of the hematoma during RPN caused contamination of RCC into the surrounding structures.
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spelling doaj-art-2f59d5ae73e1480cb3041499a48a2bb12025-02-03T01:22:23ZengWileyCase Reports in Urology2090-696X2090-69782014-01-01201410.1155/2014/975412975412Renal Cell Carcinoma Metastasis from Biopsy Associated Hematoma Disruption during Robotic Partial NephrectomyChristopher Caputo0Ziho Lee1Andrew Harbin2Daniel Eun3Department of Urology, Temple University School of Medicine, 3401 N. Broad Street, Suite 330, Zone C, Philadelphia, PA 19140, USADepartment of Urology, Temple University School of Medicine, 3401 N. Broad Street, Suite 330, Zone C, Philadelphia, PA 19140, USADepartment of Urology, Temple University School of Medicine, 3401 N. Broad Street, Suite 330, Zone C, Philadelphia, PA 19140, USADepartment of Urology, Temple University School of Medicine, 3401 N. Broad Street, Suite 330, Zone C, Philadelphia, PA 19140, USAWe describe a case in which a patient with a past medical history of ovarian cancer received a diagnostic renal biopsy for an incidentally discovered renal mass. During left robotic partial nephrectomy (RPN), a perinephric hematoma was encountered. The hematoma was not present on preoperative imaging and was likely a result of the renal biopsy. The renal cell carcinoma (RCC) and the associated hematoma were widely excised with negative surgical margins. On follow-up imaging at five months postoperatively, a recurrent renal mass at the surgical resection bed and several new nodules in the omentum were detected. During completion left robotic total nephrectomy and omental excision, intraoperative frozen sections confirmed metastatic RCC. We believe that a hematoma seeded with RCC formed as a result of the renal biopsy, and subsequent disruption of the hematoma during RPN caused contamination of RCC into the surrounding structures.http://dx.doi.org/10.1155/2014/975412
spellingShingle Christopher Caputo
Ziho Lee
Andrew Harbin
Daniel Eun
Renal Cell Carcinoma Metastasis from Biopsy Associated Hematoma Disruption during Robotic Partial Nephrectomy
Case Reports in Urology
title Renal Cell Carcinoma Metastasis from Biopsy Associated Hematoma Disruption during Robotic Partial Nephrectomy
title_full Renal Cell Carcinoma Metastasis from Biopsy Associated Hematoma Disruption during Robotic Partial Nephrectomy
title_fullStr Renal Cell Carcinoma Metastasis from Biopsy Associated Hematoma Disruption during Robotic Partial Nephrectomy
title_full_unstemmed Renal Cell Carcinoma Metastasis from Biopsy Associated Hematoma Disruption during Robotic Partial Nephrectomy
title_short Renal Cell Carcinoma Metastasis from Biopsy Associated Hematoma Disruption during Robotic Partial Nephrectomy
title_sort renal cell carcinoma metastasis from biopsy associated hematoma disruption during robotic partial nephrectomy
url http://dx.doi.org/10.1155/2014/975412
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AT andrewharbin renalcellcarcinomametastasisfrombiopsyassociatedhematomadisruptionduringroboticpartialnephrectomy
AT danieleun renalcellcarcinomametastasisfrombiopsyassociatedhematomadisruptionduringroboticpartialnephrectomy