Retroperitoneoscopic Single-Site 3D Adrenalectomy for Left Adrenal Renal Cell Carcinoma Metastasis 20 Years after Left Laparotomic Radical Nephrectomy

The aim of the paper is to demonstrate the practicability of retroperitoneoscopic single-site 3D left adrenalectomy after previous homolateral laparotomic renal surgery. We present a case report of a 70-year-old male who underwent radical nephrectomy in 1999. Twenty years after radical nephrectomy, the patient underwent a computed tomography scan for B-cell lymphoma follow-up, which revealed a 30 mm left adrenal mass suspicious for a delayed renal-cell carcinoma metastasis. After multidisciplinary discussion, surgery was chosen as first option. To minimize surgical morbidity as much as possible, a 3D laparoscopic single-site retroperitoneal approach was chosen. The patient had no peri- or intra-operative complications and was discharged on Postoperative Day 3. The final histological report revealed an adrenal clear cell renal-cell carcinoma metastasis. This experience shows that single-site retroperitoneal laparoscopic adrenalectomy is possible in patients who underwent previous abdominal cancer surgery and is an option to consider when determining optimal approaches for adrenal surgery.