The horseshoe kidney

Laparoscopic nephron-sparing surgery for horseshoe kidney complicated with renal hemangioma: a case report and literature review

In very rare cases, horseshoe kidney can present simultaneously with renal hemangioma. Nephron-sparing surgery (NSS) is a minimally invasive surgical procedure for horseshoe kidney with tumor, but it is difficult to operate and has not been reported. We report a 71-year-old female with imaging examination revealed an unexpected horseshoe kidney malformation and a cystic mass in the right kidney before her bladder cancer surgery. After one and a half years of follow-up, the mass was progressively enlarged, and was classified as Bosniak type III. After evaluating the anatomical structure around the lesion by 3D reconstruction computed tomography, she received cystoscopic right double J ureteral catheter placement combined with retroperitoneal laparoscopic partial nephrectomy of the right kidney. After a 3-month follow-up, no tumor recurrence was observed, with normal kidney function. Retroperitoneal laparoscopic NSS of horseshoe kidney with hemangioma is feasible and adequate preoperative 3D reconstruction imaging is the guarantee of safe and smooth operation.

Characterization of Associated Nonclassical Phenotypes in Patients with Deletion in the WAGR Region Identified by Chromosomal Microarray: New Insights and Literature Review

WAGR syndrome (Wilms' tumor, aniridia, genitourinary changes, and intellectual disability) is a contiguous gene deletion syndrome characterized by the joint deletion of PAX6 and WT1 genes, located in the short arm of chromosome 11. However, most deletions include other genes, leading to multiple associated phenotypes. Therefore, understanding how genes deleted together can contribute to other clinical phenotypes is still considered a challenge. In order to establish genotype-phenotype correlation in patients with interstitial deletions of the short arm of chromosome 11, we selected 17 patients with deletions identified by chromosomal microarray analysis: 4 new subjects and 13 subjects previously described in the literature with detailed clinical data. Through the analysis of deleted regions and the phenotypic changes, it was possible to suggest the contribution of specific genes to several nonclassical phenotypes, contributing to the accuracy of clinical characterization of the syndrome and emphasizing the broad phenotypic spectrum found in the patients. This study reports the first patient with a PAX6 partial deletion who does not present any eye anomaly thus opening a new set of questions about the functional activity of PAX6.