Single-Incision Laparoscopic Deroofing and Omentalization of a Cystic Renal Adenoma in a Dog

Abstract

A 12 yr old 13.5 kg male castrated Pembroke Welsh corgi was presented for evaluation of a suspected renal cyst following multiple episodes of lethargy and abdominal pain. Abdominal imaging revealed a large, thin-walled, hypoechoic cystic lesion associated with the cranial pole of the left kidney and a second smaller cystic lesion on the caudal pole. The larger cystic lesion was repeatedly drained percutaneously, but the lesion returned to initial size and clinical signs returned within weeks. Percutaneous ethanol sclerotherapy achieved only transient improvement in lesion size and abdominal discomfort. Laparoscopic deroofing and omentalization of the larger left renal cystic lesion was performed. The resected cystic wall was histopathologically consistent with a renal adenoma. Abdominal ultrasonography performed 1 mo postoperatively found no recurrence of the cystic renal adenoma. Repeated ultrasonography at 3 mo postoperatively detected a small cystic lesion at the cranial pole of the left kidney, which remained static in appearance at 11 and 18 mo postoperatively. During all follow-up visits, the dog was reported to be doing well with no recurrence of clinical signs. Renal cysts causing clinical signs and renal adenomas are rare in veterinary medicine; laparoscopic deroofing and omentalization provides a minimally invasive treatment approach.

Use of intraoperative impression smear cytology to guide successful treatment of a large renal cyst in a dog: a case report

“…RCs are rarely reported in veterinary literature [ 1 2 3 4 5 6 ]. Clinical signs associated with canine RCs are nonspecific [ 2 3 4 5 6 7 ], and oftentimes, they can be an incidental finding [ 1 2 ]. They are most commonly reported in middle-aged to older dogs [ 1 2 3 4 5 ], affecting both male [ 1 2 4 7 ] and female [ 2 3 5 8 ] dogs, as well as a variety of breeds [ 1 2 3 4 5 7 8 ].…”

“…Clinical signs associated with canine RCs are nonspecific [ 2 3 4 5 6 7 ], and oftentimes, they can be an incidental finding [ 1 2 ]. They are most commonly reported in middle-aged to older dogs [ 1 2 3 4 5 ], affecting both male [ 1 2 4 7 ] and female [ 2 3 5 8 ] dogs, as well as a variety of breeds [ 1 2 3 4 5 7 8 ]. Common examination findings in dogs with RCs include pyrexia, abdominal distension and pain, and systemic hypertension [ 5 6 ].…”

“…Common examination findings in dogs with RCs include pyrexia, abdominal distension and pain, and systemic hypertension [ 5 6 ]. Abdominal radiographic findings include a mass effect in the mid abdomen in the region of the kidney [ 5 7 ]. Ultrasonographic findings include a well-delineated, round to ovoid, anechoic to hypoechoic structure within the cortex or medulla creating acoustic enhancement, with smooth borders, a hyperechoic and thin wall, and disruption of normal renal parenchyma [ 1 2 3 4 5 7 8 ].…”

“…Principal treatment options for RCs in dogs include percutaneous drainage [ 3 7 ], sclerotherapy [ 1 3 4 6 7 ], partial nephrectomy (deroofing/fenestration) combined with omentalisation [ 2 7 ], and ureteronephrectomy [ 5 8 ]. In cases with RCs in the contralateral kidney or chronic kidney disease, performing ureteronephrectomy could be associated with morbidity if such RCs were to increase in size and cause progressive renal insufficiency.…”

“…In such cases, performing renal-sparing techniques such as sclerotherapy and partial nephrectomy may be more appropriate. However, a concern with performing such renal-sparing techniques is potential for diagnosis of neoplasia on definitive histopathology [ 7 ]. While ureteronephrectomy would be more suitable for malignant renal cystic lesions (RCLs), obtaining a preoperative diagnosis of neoplasia can be challenging [ 7 ].…”