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Turk J Urol. 2015 Sep;41(3):159-63. doi: 10.5152/tud.2015.21298. Epub 2015 Feb 18.

Robotic sequential right adrenalectomy and zero ischemia left partial nephrectomy in a patient with synchronous pheochromocytoma and renal cell carcinoma.

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Department of Urology, Yıldırım Beyazıt University Faculty of Medicine, Atatürk Training and Research Hospital, Ankara, Turkey.
Clinic of Urology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.


Currently, most renal masses are detected incidentally while still small in size because of the widespread use of radiological imaging, and most pheochromocytomas are localized in the adrenal glands as unilateral lesions. A 5 × 4-cm right adrenal mass and a 19 × 13-mm exophytic left renal mass were synchronously detected by contrast enhancement on computed tomography and magnetic resonance imaging in a 47-year-old male with hypertension. The patient's preoperative serum and 24-h urine catecholamine levels were elevated. Initially, robotic transperitoneal right adrenalectomy was performed, and histopathology confirmed a 4 cm pheochromocytoma. After 3 months, transperitoneal zero ischemia robotic left partial nephrectomy was performed, and histopathology demonstrated clear cell renal cell carcinoma, Fuhrman grade II, 17 mm in size with clear surgical margins. This case indicates that sequential robotic surgery is feasible and safe as a minimally invasive approach to remove bilateral renal and adrenal masses. Zero ischemia robotic partial nephrectomy is also feasible and safe for selected small renal masses.


Pheochromocytoma; renal cell carcinoma; robotic adrenalectomy; robotic partial nephrectomy; small renal mass; zero ischemia

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