PMC6080126_01
CT showed a solitary tumor in the right pararenal region of the retroperitoneal space 5 years after the operation (red circle).
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Five years after the operation, a solitary tumor was found in the right pararenal region of the retroperitoneal space on enhanced abdominal CT scan (Fig. 1).
Placing the patient in a prone position, a 22-gauge needle was inserted into the Gerota's fascia percutaneously and India ink and iopamiron were injected close to the tumor. The red circle shows Iopamidol which was injected para to the tumor.
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Bayer Yakuhin) (5:1) was injected para to the tumor by the radiologist (Fig. 2). Because the surgery was scheduled on Monday, we performed retroperitoneal laparoscopic resection 3 days after the marking.
Intraoperative findings. India ink which stained perirenal fat could be confirmed macroscopically. Yellow arrows show the edge of the marking of India ink on flank pad.
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Since India ink remains in place for several days, it was easy to recognize it during surgery without fluoroscopy (Fig. 3).
The resected tumor was a light yellow solid nodule (yellow arrows). An appropriate surgical margin was obtained in the resected specimen. The India ink marking on the surface of tumor was easily visualized (red arrows).
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Gross examination showed a light yellow solid nodule measuring 20 mm (Fig. 4).