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Case Reports in Urology
Volume 2012, Article ID 484790, 4 pages
http://dx.doi.org/10.1155/2012/484790
Case Report

Off-Clamp Laparoscopic Partial Nephrectomy for a Fat-Poor Angiomyolipoma Arising from the Renal Capsule: A Case Report

1Department of Urology, Toyama City Hospital, Toyama 939-8511, Japan
2Department of Pathology, Toyama City Hospital, Toyama 939-8511, Japan

Received 22 September 2012; Accepted 28 October 2012

Academic Editors: S.-S. Chen and J. Park

Copyright © 2012 Koichi Kodama et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Renal function can be significantly preserved after nephron-sparing surgery by decreasing the intraoperative ischemic duration or by performing off-clamp surgery. We report the case of a 56-year-old woman diagnosed with a minimal-fat angiomyolipoma arising from the renal capsule, which was successfully treated by retroperitoneoscopic partial nephrectomy without hilar clamping. Computed tomography revealed a 16 × 13 mm homogenous lenticular mass protruding from the lateral aspect of the left kidney. On both T1- and T2-weighted magnetic resonance images, the mass exhibited homogenous low-signal intensity and well-defined margins. Laparoscopic magnification indicated that the exophytic tumor was attached to the renal cortex by a small peduncle. The tumor was resected completely with negative surgical margin. The estimated glomerular filtration rate after surgery was nearly equal to that before surgery. Off-clamp laparoscopic partial nephrectomy is a feasible surgical option to prevent ischemic renal damage in select patients presenting with small, exophytic, and peripheral renal masses.