A Case of Pediatric Renal Cell Carcinoma With TFE3 Rearrangement Treated With Robot-Assisted Partial Nephrectomy.

Renal cell carcinoma (RCC) is uncommon in the pediatric population, and the TFE3-rearranged RCC (tRCC) subtype is characterized by translocation at Xp11.2. While robot-assisted partial nephrectomy (RAPN) is established in adult RCC treatment, its use in pediatric malignancies remains limited. We report the case of an 11-year-old boy with a progressively enlarging right renal cystic mass. Contrast-enhanced computed tomography revealed an enhancing solid component. RAPN was performed using the da Vinci Xi system, with no perioperative complications. Histopathology confirmed tRCC based on morphology and immunohistochemistry despite a negative TFE3 split FISH (fluorescence in situ hybridization) result. The patient was discharged on postoperative day 6 and remained recurrence-free at 24 months. This case illustrates the feasibility and efficacy of RAPN for pediatric RCC, suggesting that with careful planning and selection, nephron-sparing surgery may be applicable in selected pediatric oncology cases.