Klin Onkol 2025; 38(5): 386-389. DOI: 10.48095/ccko2025386.
Background: Horseshoe kidney (HSK) is the most common congenital renal fusion anomaly. While the incidence of renal cell carcinoma (RCC) in HSK is not higher than in anatomically normal kidneys, altered renal anatomy makes surgical management technically challenging. Minimally invasive, image-guided therapies such as microwave ablation (MWA) have emerged as promising alternatives. Observation: We present the case of a 65-year-old male with HSK and a 2.0 cm RCC in the right renal moiety who underwent CT-guided MWA with no complications. Hydrodissection was used to protect the psoas muscle and lumbosacral nerves. Follow-up imaging confirmed local tumor control with no signs of remnant or recurrence. Only a limited number of similar cases have been reported. Conclusion: This case highlights the feasibility and safety of percutaneous MWA for RCC in HSK. It adds to the growing evidence supporting MWA as a minimally invasive option in anatomically complex renal tumors.