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Transplanting horseshoe kidneys is challenging and has higher complication rates due to the unusual anatomy of the vascular and urinary collecting systems. Most centers avoid using these kidneys for transplantation. However, if chosen carefully, these organs can be used successfully to reduce organ shortage. In this paper, we will describe the technique of procurement of horseshoe kidneys from cadaveric donors, back table preparation, and its successful implantation in a recipient. With good planning and skillful surgical techniques, horseshoe kidneys can be successfully transplanted in suitable recipients. If properly selected, these kidneys can be used to reduce the organ scarcity and diminish waitlist morbidity and mortality.

This report describes a case of port site metastases that presented 6 months after a laparoscopic abdominoperineal resection of rectal cancer in a 75-year-old man. A surgical excision was performed to improve stoma function despite disease progression with adjuvant concurrent chemoradiation. Although port site metastases are now reported less frequently, this unfortunate consequence of laparoscopic colorectal surgery for cancer can still occur, and laparoscopic colorectal surgeons should exercise all precautions to prevent its occurrence. This report includes a review of literature on port site metastases.

Nephrogenic adenoma is a rare lesion that consists of epithelial cells arranged in tubular form, resembling tubules in the renal medulla, and is found usually in the urinary bladder although it can occur anywhere in the transitional epithelium of the lower urinary tract. The first case of nephrogenic adenoma of the urinary bladder was reported before the first kidney transplantation, and the lesion has been reported in patients with and without renal transplantation. The origin of cells in nephrogenic adenoma is debated and has been postulated to arise from cells of embryonic origin or from metaplasia secondary to chronic irritation or from implantation of allograft cells in patients with kidney transplantation. The long-term outcome and potential to convert into malignancy are not established, and therefore, there are no recommendations on how to follow up these patients. We present a case of a patient who was found to have nephrogenic adenoma of the urinary bladder during his second kidney transplantation from a cadaveric donor. He had undergone living donor kidney transplantation previously which subsequently failed. The patient did not manifest any symptoms of nephrogenic adenoma. During a follow-up period of 5 years, he has not manifested any symptoms related to nephrogenic metaplasia. Histopathological examination 5 years after the second transplantation did not show any malignant change. It can be concluded that nephrogenic adenoma is likely to behave in benign fashion post kidney transplantation.