Two Cases of Ascending Colon Carcinoma with Concomitant Horseshoe Kidney Treated by Laparoscopic Right Hemicolectomy

Abstract

Patient 1 was an 85-year-old woman who had presented at another hospital complaining of loss of appetite. Based on computed tomography (CT), ascending colon carcinoma with multiple liver metastases was diagnosed. Preoperative contrast-enhanced CT also showed a horseshoe kidney, but a duplicate ureter was not evident, and the courses of the ovarian artery and vein were not anomalous. Laparoscopic right hemicolectomy and D3 lymph node dissection were performed. Because the right renal pelvic ureter ran on the ventrolateral side of the horseshoe kidney, the mesocolon and renal pelvic ureter were somewhat difficult to detach via the medial approach. Patient 2 was an 80-year-old man whose tumor markers were found to be high at a regular health checkup, and he was diagnosed with ascending colon carcinoma on further investigation. Preoperative contrast-enhanced CT showed a horseshoe kidney, but there was no duplicate ureter, and the courses of the testicular artery and vein were not anomalous. Laparoscopic right hemicolectomy, D3 lymph node dissection, and combined resection of the right testicular artery and vein were performed. The course of the right ureter was more medial than its usual course, running along the ventral side of the isthmus of the horseshoe kidney. There has been no previous report of right colon cancer with a concomitant horseshoe kidney, and these cases are reported with a short discussion of the literature on points to note with respect to the ureteral course during surgery.