PMC9316585_01
CT of the small, totally endophytic renal mass. (A-C) An enhancing endophytic mass(black arrow) measuring 1.6x1.4 cm was observed in the middle part of the right kidney. Slight shrinkage (*) was noted and taken as a puncture reference. During the excretory phase, the mass (black arrow) showed a different enhancement pattern (contrast washout) on coronal (D) and sagittal (E) views. (F) After the microcoil was implanted targeting the lesion, abdominal CT was performed to confirm the position of the microcoil and search for any complications.
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Figures 1A-E ). For the purpose of partial nephrectomy, 8 and 4 points were evaluated according to PADUA and SPARE nephrometry scoring systems, respectively. A tornado-like radio-opaque microcoil (MWCE-18S-6/2-TORNADO, Cook Medical, Bloomington, IN, USA) was implanted into the renal parenchyma targeting the small renal mass ( Figure 1F ).
Representative images showing the main steps in video-assisted laparoscopy surgery for the resection of small, totally endophytic renal mass localized preoperatively with the microcoil. (A) The microcoil tail (white arrow) was visualized during laparoscopy. (B) The excised specimen after partial nephrectomy showed an intact tumour with a clear margin. (C) Microscopic sections of the mass showed large polygonal cells with clear cytoplasm and centrally placed small nuclei, indicating renal clear cell carcinoma (haematoxylin-eosin, original magnification 200x).
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Laparoscopic exploration of the retroperitoneal cavity revealed the implanted microcoil protruding from the dorsal surface of the right kidney ( Figure 2A ). The mass was completely removed without excessive damage to the renal vasculature or collecting system ( Figure 2B ). T1a renal cell carcinoma (RCC, American Joint Committee on Cancer TNM stage), WHO/ISUP grade 2 ( Figure 2C ), 16 mm in greatest dimension. The tumour did not involve the perirenal capsule and was at least 2 mm away from the surgical margin.