Will not bagging an excised tumour immediately during partial nephrectomy possibly result in tumour seeding? A case report

Partial nephrectomy is now a standard approach for small renal masses and tumour recurrences after partial nephrectomy are uncommon. In the absence of spillage, port site recurrences are most commonly reported. We report a case of tumour recurrence near the surgical site as well as beyond the posterior renal fascia and Gerotas fascia in a 60-year-old woman who underwent robot-assisted partial nephrectomy for a 4.6 cm suspicious left renal tumour despite the absence of gross tumour spillage or rupture intraoperatively. Histology showed a 5 cm clear cell renal cell carcinoma with negative surgical margins, nuclear grade 4 with focal malignant rhabdoid differentiation. The practice of not bagging the specimen immediately after tumour excision especially for higher risk tumours should be reviewed as there may be inadvertent microscopic spillage of tumour cells.