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Rarely occurring at birth, crossed renal ectopia is an abnormality in which both kidneys occupy the same side of the body while one ureter - its length based on kidney location - traverses across midline to graft into opposite-side bladder.McDonald and McClellan classified renal ectopia into 4 types.Solitary crossed renal ectopia (SCRE) is an extremely uncommon abnormality of the urinary system. To date, only 35 instances have been documented in published literature. Typically, these cases are detected by chance during patient assessments for related issues such as genitourinary, cardiovascular, hematological or vertebral abnormalities.

Colorectal cancer and its diagnosis remain a significant clinical problem. Renal ectopia is one of the major developmental anomalies of the urinary system, although it is relatively rare in the general population. It is most often asymptomatic and is revealed by chance. This study presents a case report of a 43-year-old man, in whom colorectal cancer was suspected due to the suggestive clinical picture (abdominal pain, constipation, weight loss, a family history of colorectal cancer) and the suspicion of a proliferative process described in an outpatient ultrasound examination of the abdominal cavity. As a result of the performed diagnostics, no proliferative process was found in the patient, and the previously diagnosed lesion that raised the suspicion of cancer turned out to be the right kidney located in the pelvis. The presented case report shows that renal ectopia may cause diagnostic difficulties, among others in patients diagnosed with a neoplastic process.

This report explores the diverse spectrum of congenital anomalies of the kidney and urinary tract (CAKUT), ranging from asymptomatic presentations to the most severe form characterized by bilateral renal agenesis. Genitourinary anomalies, a prevalent subset within this domain, account for a significant proportion, constituting 15–20% of anomalies identified during prenatal screening. An ectopic kidney is defined by the presence of an empty renal fossa and the displacement of the kidney from the lumbar region to alternative locations, with the pelvic region emerging as the most prevalent site. The reported case involves bilateral renal ectopia with unilateral duplex kidney. Initial suspicions of a renal anomaly arose during the first trimester, leading to a definitive diagnosis in the second trimester. The patient underwent regular monitoring every four weeks, ultimately delivering a healthy baby at term. This case underscores the frequency of renal anomalies, emphasizing that a considerable proportion remains asymptomatic. These findings contribute to a broader understanding of congenital renal anomalies, their varied manifestations, and the importance of vigilant prenatal screening for early detection and management. [ABSTRACT FROM AUTHOR]

Introduction: Wilms tumor is the most common renal malignancy in children. The occurrence of Wilms tumor with various congenital genitourinary anomalies has been reported, particularly in horseshoe kidneys, hypospadias, disorder of sexual development, and double collecting system. However, Wilms tumor with crossed renal ectopia is a rare finding. Case Description: We are reporting a case report of Wilms tumor in a 3-year-old girl who presented with a huge left flank mass with cross-fused renal ectopia. After the initial workup and triphasic computed tomography (CT) scan of the chest, abdomen, and pelvis for confirmation of diagnosis and metastasis, the patient underwent image-guided tissue biopsy followed by neo-adjuvant chemotherapy, left radical nephrectomy with separation of fused right ectopic renal moiety and adjuvant chemoradiation. Practical Implication: This report shows an association of Wilms tumor with cross-fused renal ectopia, a rare combination. Unusual findings on imaging with unilateral flank mass should be considered as part of the differential diagnosis for this rare finding. Adjuvant chemotherapy and modern imaging helped delineate the anatomy and ease the surgery for safe resection, improving the overall outcome.

This report explores the diverse spectrum of congenital anomalies of the kidney and urinary tract (CAKUT), ranging from asymptomatic presentations to the most severe form characterized by bilateral renal agenesis. Genitourinary anomalies, a prevalent subset within this domain, account for a significant proportion, constituting 15–20% of anomalies identified during prenatal screening. An ectopic kidney is defined by the presence of an empty renal fossa and the displacement of the kidney from the lumbar region to alternative locations, with the pelvic region emerging as the most prevalent site. The reported case involves bilateral renal ectopia with unilateral duplex kidney. Initial suspicions of a renal anomaly arose during the first trimester, leading to a definitive diagnosis in the second trimester. The patient underwent regular monitoring every four weeks, ultimately delivering a healthy baby at term. This case underscores the frequency of renal anomalies, emphasizing that a considerable proportion remains asymptomatic. These findings contribute to a broader understanding of congenital renal anomalies, their varied manifestations, and the importance of vigilant prenatal screening for early detection and management.

Intrathoracic ectopic kidney is the rarest form of ectopic kidneys. Intrathoracic kidneys do not seem to be associated with an increased risk of complications, such as renal stone formation, infection, or reduced renal function, and most cases are asymptomatic. It should be kept in mind when renal tissue cannot be observed in the renal fossa or pelvic area in ultrasonography. Asymptomatic cases with eventration usually do not require any surgical intervention and follow-up is appropriate. We aimed to present a case of an intrathoracic kidney with diaphragmatic eventration, diagnosed by imaging performed in a patient presenting with bilateral flank pain. [ABSTRACT FROM AUTHOR]

Ureteral triplication is one of the least encountered congenital malformations of the upper urinary tract. We report a case of a 37-year-old male patient with right renal ectopia with triplication of the ureter which was diagnosed via computed tomography (CT) urography. This is an intriguing example because, as we discovered after reviewing the literature, the presentation is distinctive. [ABSTRACT FROM AUTHOR]

Abstract Background Right-side fixation of the sigmoid colon is a rare anatomical variant associated with intestinal malrotation (Choi et al. in J Korean Surg Soc. 84(4):256–60, 2013). Differently from other forms of malrotation, this variant has not been associated thus far with acute surgical conditions. Case presentation In this report, we present a 65-year-old Caucasian patient admitted for bowel obstruction symptoms. Computed tomography scan revealed right-side fixation of the sigmoid colon extended to the subhepatic recess complicated by obstructed internal herniation of the ileum. In this patient, the sigmoid colon occupied a recess posterior to the ascending colon and right Toldt’s fascia. Within this narrow anatomical space, an ileal loop was trapped causing internal herniation with resultant close-bowel obstruction of both ileum and sigmoid colon. The ileal loop was released surgically and the anatomical abnormality corrected. Conclusions To our knowledge, this is the first case of right-side fixation of the sigmoid colon causing acute obstruction secondary to internal herniation of the small intestine. Early recognition and precise anatomical definition of such anatomical variants are essential to optimize their surgical approach.

Background: Right-side fixation of the sigmoid colon is a rare anatomical variant associated with intestinal malrotation (Choi et al. in J Korean Surg Soc. 84(4):256-60, 2013). Differently from other forms of malrotation, this variant has not been associated thus far with acute surgical conditions.Case Presentation: In this report, we present a 65-year-old Caucasian patient admitted for bowel obstruction symptoms. Computed tomography scan revealed right-side fixation of the sigmoid colon extended to the subhepatic recess complicated by obstructed internal herniation of the ileum. In this patient, the sigmoid colon occupied a recess posterior to the ascending colon and right Toldt's fascia. Within this narrow anatomical space, an ileal loop was trapped causing internal herniation with resultant close-bowel obstruction of both ileum and sigmoid colon. The ileal loop was released surgically and the anatomical abnormality corrected.Conclusions: To our knowledge, this is the first case of right-side fixation of the sigmoid colon causing acute obstruction secondary to internal herniation of the small intestine. Early recognition and precise anatomical definition of such anatomical variants are essential to optimize their surgical approach. [ABSTRACT FROM AUTHOR]

The kidney is an organ prone to congenital anomalies owing to its complex and sequential development. Ectopia of the kidney is a rare entity with intrathoracic ectopia being an exceptionally uncommon occurrence. Intrathoracic kidneys represent less than 5% of all renal ectopias with a prevalence rate of less than 0.01%. The concurrent association of an intrathoracic kidney with a Bochdalek hernia is extremely infrequent with an incidence of 0.25%. Most of the patients are asymptomatic and have an uneventful clinical course. It is often incidentally detected simulating a posterior mediastinal mass. Thoracic kidney is a condition that shows male predominance. Here, authors present a case of a 43-year-old female patient who presented to the Institution with breathlessness and associated chest pain. Computed Tomography (CT) scan revealed left-sided Bochdalek hernia with the left kidney, adrenal gland, transverse colon, splenic flexure and proximal descending colon within the thorax. The patient underwent elective diagnostic laparoscopy followed by reduction of the contents and mesh repair of the diaphragmatic defect. The patient was discharged and remained asymptomatic on a periodic follow-up of over a year. Awareness regarding this rare entity can obviate the need for a battery of unnecessary investigations and operative procedures.

Comprehensive preoperative evaluation of potential donors is crucial for selecting the right donor. Early segmentary arterial branching is present in 10%–12% of cases. Expert surgeons require at least 1 cm of main donor renal artery to clamp and properly anastomose the artery in the recipient. We report a case of live-related renal transplantation wherein the recipient had a crossed renal ectopia and the donor had early branching of the left renal artery (

Abstract Background The incidence of ectopic kidneys is 1:12,000 clinically and 1:900 postmortem. Patients with pelvic mal-rotated kidneys are more susceptible to recurrent urinary tract infections, recurrent renal stones, and renal injury. Fusion of the kidney lower poles is relatively common compared to other types of renal anomalies. Case presentation We present the case of a 36-year-old Sudanese female patient who presented with a long history of recurrent urinary tract infections unresponsive to antibiotics. Ultrasound scan revealed bilateral pelvic kidneys. Computed tomography (CT) urography confirmed bilateral ectopic fused kidneys, with the left kidney mal-rotated (renal pelvis facing upwards and laterally). Kidney infection secondary to vesicoureteral reflux was diagnosed. Antibiotics were prescribed according to culture and sensitivity. The patient responded well to ciprofloxacin. Conclusion A history of recurrent urinary tract infections without an apparent cause is highly suggestive of renal anomaly and should be investigated expediently. Ultrasonography or CT imaging may be utilized to aid in diagnosis. Early recognition may help prevent the high risk of end-stage renal failure associated with anomalies.

Renal ectopia, a rare congenital anomaly, can occur in various body regions and may be associated with other abnormalities. It is often asymptomatic, commonly found incidentally, as in our 70-year-old patient during appendicitis exploration. This case highlights the importance of recognizing renal ectopia and associated anomalies, such as vascular abnormalities and renal malrotation, which may predispose patients to potential complications and require vigilant monitoring for urinary tract infections and lithiasis events, as well as potential challenges during laparoscopic surgical procedures, as in our appendectomy case. A 70-year-old female presented with right iliac fossa pain and elevated inflammatory markers. Abdominopelvic CT scan confirmed uncomplicated appendicitis and revealed a right ectopic and malrotated kidney. Laparoscopic appendectomy was performed without complications. Postoperative recovery was uneventful, and discharge occurred one day post-procedure. A four-week follow-up was scheduled to monitor for urinary infection and stone formation, with initiation of hygienic and dietary measures. Renal ectopia, a congenital anomaly, frequently positions the kidneys in the pelvic region. Iliac ectopias are often confused with pelvic or abdominal ectopias. Ectopic kidneys can result in complications like vesicoureteral reflux, urinary tract infections, or kidney stones. Despite being typically left-sided, our patient presented with right-sided renal ectopia with malrotation. Despite lacking urinary symptoms, a urological consultation was advised due to the potential risk of infection or kidney stones. Surgical intervention is reserved for complication management. Renal ectopia, a rare congenital anomaly, can be asymptomatic but often coincides with other renal or vascular issues. Early detection and accurate imaging are essential, emphasizing clinical vigilance and interdisciplinary collaboration for better patient care. • Incidental finding of right renal ectopia with malrotation during CT scan for appendicitis. • Significance of thorough imaging and patient-centered proactive care. • Risk of complications like urinary infections or kidney stones. • Advancements in medical imaging aiding informed decision-making. [ABSTRACT FROM AUTHOR]

Background: Renovascular hypertension (RVH) accounts for 5-10% of arterial hypertension in children and is most commonly caused by fibromuscular dysplasia. Sporadically, renal artery stenosis in pediatric patients is caused by extrinsic compressive masses. Case report: A 12-year-old patient with complex urinary tract defect (dysplastic left kidney -- nephrectomy at 11 months, right ectopic kidney in the midline, behind the urinary bladder), chronic kidney disease (CKD) stage 2, and arterial hypertension was admitted to the hospital due to worsening of kidney function during angiotensin-converting enzyme inhibitor (ACE-I) therapy. CT angiography revealed a right ectopic kidney located above the bladder, supplied by a single renal artery originating from the right common iliac artery. The renal artery had a tortuous shape with width in the ostium approx. 4.5 mm; then, the artery was bent and ran between the common iliac artery and the kidney. Ultrasound performed with a filled bladder showed bending and stenosis of the renal artery at the origin from the right common iliac -- peak systolic velocity (PSV) 4.5-5.5 m/s and renal-aortic ratio (RAR) 3.1. With an empty bladder, no bending or stenosis was visible (PSV 1.7-1.9 m/s and RAR 1.0). Uroflowmetry revealed a dysfunctional micturition curve, large bladder capacity, and post-void urine retention. ACE-I was changed to beta-blocker and doxazosin, which led to blood pressure and kidney function normalization. Conclusions: Renal ectopia associated with bladder dysfunction may result in renal artery stenosis causing renovascular hypertension. [ABSTRACT FROM AUTHOR]

Renal ectopia, even though a benign condition, presents diagnostic challenges when its complications arise. Cold abscess in an abnormally sited kidney may, therefore, create a diagnostic conundrum for the clinician. We present the case of a 55-year-old male who had a suppurating ectopic kidney that mimicked an abdominal visceral mitotic lesion necessitating initial laparotomy, reviewed the literature, and highlighted the need to consider the differential diagnosis, especially in patients who have been referred from peripheral hospitals where generous antibiotic therapy has been instituted. We also recommend undertaking a preoperative split renal scintigraphy where available, especially when nephrectomy is considered.

Fused renal crossover ectopia is a rare entity within the spectrum of congenital anomalies of urinary tract development, with an estimated incidence of approximately one in 1000 live births and a male predilection in a two to one ratio when compared to the female population. This entity is usually asymptomatic in most patients. The presence of symptoms is usually linked to a spectrum of complications, including hydronephrosis, infections, bile-ureteral reflux and nephrolithiasis. Recognizing the low incidence of this anomaly and the importance of its identification, in this article we report a case from our institution, observed as an incidental finding in a contrasted abdominopelvic tomography for non-specific abdominal pain. [ABSTRACT FROM AUTHOR]

Primary renal chondrosarcomas are rare tumors that are high-grade in nature and, unfortunately, have poorly understood pathogenesis and extremely low prognosis. The coexistence of a discrete malignancy in the urinary bladder is even rarer, with the occurrence of distinct papillary urothelial carcinoma in the urinary bladder in this case. The clinical presentation is nonspecific, and the primary radiological investigations have a limited scope in providing specific diagnosis of this entity. The final diagnosis is possible on thorough histopathological examination of the resected specimen, which requires extensive sampling and meticulous reporting. As of now, the only way to achieve a better prognosis is by early diagnosis. It is necessary to keep the possibility of occurrence of sarcomas at rare sites in the differential diagnoses. The cytogenetic and molecular abnormalities associated with this entity need to be elucidated to achieve a more satisfactory outcome concerning the overall management of the patient. [ABSTRACT FROM AUTHOR]

Abstract Background The case report describes a rare congenital anomaly, crossed fused renal ectopia (CFRE), with coexistence of two other abnormalities – atypical portal vein and coccygeal vertebrae malformation in a domestic cat. The concomitance of those 3 congenital defects has not been described previously. Case presentation An 8-month-old female, domestic cat suffering from chronic diarrhea was referred to the diagnostic imaging unit. The patient showed no other clinical symptoms. An abdominal ultrasonographic examination was performed in order to evaluate the condition of abdominal organs, particularly the gastrointestinal tract. The ultrasound examination showed an ectopic duplex kidney at instead of kidneys in their typical location. Computed tomography (CT) with angiographic phase and excretory urography was requested to evaluate the condition of the kidneys and ureters. The final diagnosis was CFRE, atypical portal vein and coccygeal deformation in an asymptomatic cat with no changes in renal function and normal blood parameters. Conclusions Crossed fused renal ectopia is a rare congenital anomaly and is easily detectable by an abdominal ultrasonographic examination and CT, which allows more complete assessment of both anatomical relations and secretory function of the kidney. The occurrence of CFRE, abnormal portal vein and spinal malformation in a clinically healthy patient is the evidence that congenital malformations may simultaneously involve various, not directly related structures and systems, without significant influence on blood and urine parameters. Thus the most useful tool in the evaluation of the morphological and functional changes is the diagnostic imaging, especially contrast enhanced CT. Our results show that renal fusions should be considered in the differential diagnosis of caudal abdominal masses.

Primary renal chondrosarcomas are rare tumors that are high-grade in nature and, unfortunately, have poorly understood pathogenesis and extremely low prognosis. The coexistence of a discrete malignancy in the urinary bladder is even rarer, with the occurrence of distinct papillary urothelial carcinoma in the urinary bladder in this case. The clinical presentation is nonspecific, and the primary radiological investigations have a limited scope in providing specific diagnosis of this entity. The final diagnosis is possible on thorough histopathological examination of the resected specimen, which requires extensive sampling and meticulous reporting. As of now, the only way to achieve a better prognosis is by early diagnosis. It is necessary to keep the possibility of occurrence of sarcomas at rare sites in the differential diagnoses. The cytogenetic and molecular abnormalities associated with this entity need to be elucidated to achieve a more satisfactory outcome concerning the overall management of the patient.

Crossed fused renal ectopia (CFRE) is a rare congenital anomaly in which a kidney is located on the opposite side from where its ureter connects to the bladder, merging into the other kidney. It has been linked to other rare congenital malformations, including the VACTERL association (vertebral anomalies, anal atresia, cardiac anomalies, tracheoesophageal fistula, esophageal atresia, renal anomalies, and limb abnormalities), the MURCS association (müllerian ducts, renal, and cervicothoracic spine anomalies), increased incidence of infections, obstruction, cystic dysplasia, and urolithiasis. Although the literature has documented only a small number of cases wherein CFRE coincides with neoplasia, we present the case of a 59-year-old patient with a right ectopic kidney fused to the left one and simultaneous primary renal cell carcinoma. We aim to report and discuss this case and the treatment approach, comparing it with existing literature to enhance our understanding and management of similar occurrences, as partial nephrectomy is uncommon due to the challenging anatomy of these cases., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Kaça do Carmo et al.)

Comprehensive preoperative evaluation of potential donors is crucial for selecting the right donor. Early segmentary arterial branching is present in 10%--12% of cases. Expert surgeons require at least 1 cm of main donor renal artery to clamp and properly anastomose the artery in the recipient. We report a case of live-related renal transplantation wherein the recipient had a crossed renal ectopia and the donor had early branching of the left renal artery (<5 mm from the aorta). [ABSTRACT FROM AUTHOR]

A 61-year-old man who was a psychiatric patient and an alcoholic was admitted to hospital after a fall in his bathroom. He showed signs of hemorrhagic shock, and CT scans showed the presence of the right kidney and part of the right retroperitoneum in the right hemithorax, surrounded by liquid. Surgery showed that the right hemidiaphragm was intact and that no intraabdominal viscera prolapsed into thoracic cavity. The bleeding in the right retroperitoneum was evacuated. The surgical report also stated that "the right kidney and ureter were explored and no injuries or active bleeding were found". The patient died the third day after admission. Autopsy revealed a livid swelling covered with parietal pleura in the right half of the thoracic cavity, behind the costophrenic sinus, about 20 × 15x12 cm in size, filled with about 1500 ml of blood, with ectopic right kidney in the right half of the thorax, slightly rotated posteriorly and downwards. The kidney was smaller (80 g in weight), compared to the normally positioned enlarged left kidney (300 g). The right hemidiaphragm was also intact with small Bochdalek's foramen behind the posterior edge, with communication between the right retropleural and retroperitoneal spaces, through which intact elongated right renal artery (15 cm), vein (14 cm) and ureter were passing. The cause of death was hemorrhagic shock due to retroperitoneal bleeding, with coagulation disorder as possible contributing factor. Intrathoracic kidneys may pose many diagnostic and management dilemmas for clinicians and pathologists. Association between a Bochdalek hernia and an intrathoracic renal ectopia is very rare and may be confusing for doctors in different clinical situations. [ABSTRACT FROM AUTHOR]

Objective: Our aim is to present the anomalies included empty renal fossa (ERF) in the ultrasonographic examination performed in the perinatology outpatient clinic of our hospital in 2020. Methods: Ultrasonography requests were made in Kayseri City Hospital Perinatology Outpatient Clinic between January 1 and December 31, 2020, and 2405 ultrasonographic examinations were performed on 1961 pregnant women. The reports of the patients were analyzed retrospectively after the ethics committee approval of our hospital was obtained. All ultrasonographic examinations were performed by an experienced perinatologist using Samsung HS70A (Hampshire, UK), probe CA 1-7A. The fetuses diagnosed with empty renal fossa were screened in terms of accompanying anomalies and the detected anomalies were noted. Results: Pregnant women were between 13 and 34 (mean 23.9) years old and their gestational ages were between 17 and 34 weeks. The incidence of ERF was found to be 0.75% for all pregnant women. An ERF finding was observed in a total of 15 fetuses. Horseshoe kidneys were present in four fetuses (0.20%), bilateral renal agenesis was present in five fetuses (0.25%), left renal agenesis was present in two fetuses (0.10%), pelvic kidneys (one on the right and two on the left) were present in three fetuses (0.15%), and crossed fused ectopic kidney was present in one fetus (0.05%). Conclusion: The cause of ERF seen with anhydramnios is bilat-eral renal agenesis. In the presence of normal amniotic fluid, it should be considered that ERF may be due to various reasons and since the prognosis may change according to the accompanying anomalies, we must increase the accuracy of prenatal diagnosis. [ABSTRACT FROM AUTHOR]

Crossed fused renal ectopia (CFRE) is an uncommon developmental anomaly of the genitourinary system whereby the two kidneys are located on the same side of the body and joined together, while the ureter of the ectopic kidney still enters the bladder in its normal side. CFRE has variable clinical presentations and usually discovered incidentally when patients are investigated for abdominal complaints. Treatment may be conservative when renal function is preserved with no associated symptomatic urological complications. Highlighted here is the unusual presentation of left-to-right CFRE with acute pyelonephritis as an appendix mass in a 19-year-old female.

Crossed renal ectopia (CRE) is a rare congenital anomaly in which both kidneys reside in one side. It could be detected incidentally or during the late stage when the kidney is functioning poorly or even being non-function. We report a case of 12 years old child with symptoms of right flank pain and dysuria due to urinary tract infection (UTI). We performed routine laboratory tests (blood and urine) along with whole abdominal Ultrasonography (US) and abdomenopelvic CT-Scan. Both kidneys were located in the right side joining in the upper and lower poles with both ureters draining separately in urinary bladder. No any other anomalies related to the kidneys (congenital obstruction and cystic anomalies) and other organ system were detected. We treated UTI appropriately and discharged the patient with advice.

Background: The incidence of ectopic kidneys is 1:12,000 clinically and 1:900 postmortem. Patients with pelvic mal-rotated kidneys are more susceptible to recurrent urinary tract infections, recurrent renal stones, and renal injury. Fusion of the kidney lower poles is relatively common compared to other types of renal anomalies.Case Presentation: We present the case of a 36-year-old Sudanese female patient who presented with a long history of recurrent urinary tract infections unresponsive to antibiotics. Ultrasound scan revealed bilateral pelvic kidneys. Computed tomography (CT) urography confirmed bilateral ectopic fused kidneys, with the left kidney mal-rotated (renal pelvis facing upwards and laterally). Kidney infection secondary to vesicoureteral reflux was diagnosed. Antibiotics were prescribed according to culture and sensitivity. The patient responded well to ciprofloxacin.Conclusion: A history of recurrent urinary tract infections without an apparent cause is highly suggestive of renal anomaly and should be investigated expediently. Ultrasonography or CT imaging may be utilized to aid in diagnosis. Early recognition may help prevent the high risk of end-stage renal failure associated with anomalies. [ABSTRACT FROM AUTHOR]

Knowledge of anatomical anomalies is significant for all specialists in clinical practice and may prevent serious complications following medical procedures. This report presents the rare crossed fused renal ectopia (CFRE) with atypical renal vasculature in cadaver of a 68-year-old man. The ectopic kidney was located on right side with four renal veins, three renal arteries, two ureters, where one of them is double. The embryological background, as well as the potential clinical significance of this morphological variation, is discussed. An interventional radiological and surgical procedure should be appropriately implemented to treat anomalies of vessels and CFRE. [ABSTRACT FROM AUTHOR]

Renal ectopia, even though a benign condition, presents diagnostic challenges when its complications arise. Cold abscess in an abnormally sited kidney may, therefore, create a diagnostic conundrum for the clinician. We present the case of a 55-year-old male who had a suppurating ectopic kidney that mimicked an abdominal visceral mitotic lesion necessitating initial laparotomy, reviewed the literature, and highlighted the need to consider the differential diagnosis, especially in patients who have been referred from peripheral hospitals where generous antibiotic therapy has been instituted. We also recommend undertaking a preoperative split renal scintigraphy where available, especially when nephrectomy is considered. [ABSTRACT FROM AUTHOR]

Congenital diaphragmatic herniae (CDH) with associated intrathoracic ectopic kidneys are rare congenital anomalies, with a reported incidence of only 0.25%. The authors report a case of a 24-day-old baby girl who was diagnosed with a left-sided CDH on a chest X-ray taken for pneumonia. Computed tomography scan showed CDH hernia, containing small and large bowel and whole left kidney with adrenal gland. Thoracoscopic reduction in the bowel, kidney, and adrenal gland into the abdomen and primary closure of the defect was achieved with no complications. During investigation of the child, it was discovered that her maternal aunt had also had a left-sided congenital diaphragmatic hernia containing the kidney, which was treated via open surgery after birth; she subsequently developed renal cell carcinoma and required radical nephrectomy of that kidney during her third decade.

Introduction: Renal ectopia is an uncommon congenital condition, where kidney is misplaced and malrotated. Results: In the present study, it was found that the right kidney had a lower position (at the level of L2 to L5) than usual. The hilum of the right kidney was facing anterolaterally and had two renal pelvises. The right kidney was supplied by five renal arteries and the left one by two renal arteries. Discussion: Renal ectopia occurs due to abnormal ascend and rotation of the kidney. The majority of ectopia cases were reported in the pelvic region, but in the present study it was found in the abdominal region. Conclusion: Ectopic kidney may occur due to abnormal ascent and rotation of kidney. It may be associated with vascular and ureteric anomalies. [ABSTRACT FROM AUTHOR]

The congenital renal anomalies of migration, structure and function are the result of a cephalic migration alteration from the pelvis to the ureteric bud and mesonephric blastemal of the renal fossa. This process stars in the fifth week of its gestation period and finishes in the ninth week. Kidney malformations are not frequent and they rarely have a clinic meaning. Among the migration urinary tract anomalies are: the simple renal ectopia, and regarding structure and fusion, the crossed renal ectopia and the horseshoe kidney. Generally, this disease is asymptomatic since it is casually discovered by radiation or other means. The symptomatic cases that present repeated urinary infections or obstructive uropathy are not frequent. In this paper, we will go into a weird variation of structure and fusion; the crossed renal ectopia. The crossed renal ectopia is the second fusion anomaly regarding frequency after the horseshoe kidney. Two cases of crossed renal ectopia are described in this paper, one of which has been found in the Subject of Anatomy at Universidad de Mendoza, and the other is about radiologic discoveries of registered cases from a patient in the Nephrology Service at Hospital Central de Mendoza. [ABSTRACT FROM AUTHOR]

Crossed fused renal ectopia is a rare congenital malformation, wherein both kidneys are present unilaterally, with the ureter of the crossed kidney opening into the bladder on the contralateral side. It has varied presentation from incidental detection to renal impairment. In this largest series of crossed fused renal ectopia, the authors assessed the clinical profile of these children and also attempted to shed light on the challenges in the surgical management. It is a retrospective study conducted from January 2009 to July 2018, among patients evaluated for crossed fused ectopia, in the Department of Pediatric Surgery, Christian Medical College, Vellore. Electronic medical records of 36 children were reviewed. Imaging modalities and operative interventions were recorded. Results were analyzed. A total of 36 children were found to have crossed fused ectopia, with male preponderance. Most children presented within one year of age with urinary tract infection being the commonest cause. The most common associated anomaly was anorectal malformation. Ultrasound abdomen and pelvis, micturating cystourethrogram, and radionucleotide scans were the imaging modalities preferred for diagnosis and follow-up. Left-to-right ectopia was more common with inferior ectopic variant being the most common. The predominant urological problems include pelviureteric junction obstruction, vesicoureteric junction obstruction, and vescioureteric reflux. Ureteric re-implant was the most common surgery performed followed by pyeloplasty. Pelvi-pelvostomy, uretero-ureterostomy, bladder augment with Mitrofanoff, and other procedures were performed for select cases. Crossed fused renal ectopia is a challenging entity which requires individualized management plans based on the predominant urological anomaly and the functional status. Surgical options are diverse and are guided toward the symptomatic urological problem with focus on preserving the renal function. The long-term prognosis is good in these children. [ABSTRACT FROM AUTHOR]

The fused crossed renal ectopia presents an incidence of 1:1000 live births. It is more frequent in men with a ratio of 2:1 and left-right ectopia is the most frequent and is associated with lithiasis formation in 9%, the diagnosis is made by conventional imaging studies and the treatment is aimed at complications more than the anatomical alteration itself. We present the case of a 44-years-old male patient who began with abdominal pain in the right renal fossa, associated with recurrent urinary tract infections, requesting a CT scan documenting crossed renal ectopia and pyelic lithiasis. We decided to perform endourological treatment, performing percutaneous nephrolithotomy guided by ultrasound, fragmenting all the lithiasic load, remaining free of stones. [ABSTRACT FROM AUTHOR]

Crossed renal ectopy (CRE) is a very rare congenital kidney anomaly. CRE is usually asymptomatic and is most often discovered incidentally, but the patient may sometimes develop various renal manifestations. We report a case of a girl who was symptomatic of several episodes of urinary tract infections and whose investigations including ultrasound, uroscan, renal scan and voiding cystourethrogram concluded that she had a crossed left renal ectopy without vesico-ureteral reflux. A regular Follow-up revealed no further symptoms or complications, with partial resolution of the hydronephrosis, and no recurrence of urinary tract infections after hygienic rules. This case didn't require surgical intervention. CRE is an infrequently occurring congenital malformation. Uroscan is an excellent tool to describe the full anatomical details of this pathology; and the information provided is crucial for surgeons, nephrologists, and radiologists to aid in the proper handling of this pathology. CRE is a rare disease that can be diagnosed incidentally. Treatment is only indicated if complications occur or if there is other associated renal disease. Patients require continuous follow-up and need to be examined for potential complications. • Crossed renal ectopy is a rare congenital malformation. It is usually asymptomatic and is most often discovered incidentally • Patients may sometimes develop various renal manifestations. • This manuscript describes a case of an infrequently occurring renal anomaly, and the diagnostic tools to aid in the proper handling of this pathology. • This manuscript includes also a discussion of the further investigations and the management required to establish the diagnosis. [ABSTRACT FROM AUTHOR]

Crossed fused renal ectopia (CFRE) is an uncommon developmental anomaly of the genitourinary system whereby the two kidneys are located on the same side of the body and joined together, while the ureter of the ectopic kidney still enters the bladder in its normal side. CFRE has variable clinical presentations and usually discovered incidentally when patients are investigated for abdominal complaints. Treatment may be conservative when renal function is preserved with no associated symptomatic urological complications. Highlighted here is the unusual presentation of left-to-right CFRE with acute pyelonephritis as an appendix mass in a 19-year-old female. [ABSTRACT FROM AUTHOR]

Renal ectopia is a rare anomaly which may occur due to an abnormal ascent of the kidney. It is usually asymptomatic and does not require treatment. Intrathoracic renal ectopia with concomitant congenital diaphragmatic hernia (CDH) is extremely rare. All symptomatic CDH cases must be treated with open or thoracoscopic repair. During plication of the diaphragm, care must be taken to avoid renal injury. Following, we present two rare variants of CDH with concomitant renal ectopia managed thoracoscopically. Post-operative recovery was uneventful. Doppler ultrasound study performed one month after surgery confirmed normal vascularity of the kidneys and the absence of urinary outflow obstruction.

Müllerian duct aplasia–renal agenesis–cervicothoracic somite dysplasia (MURCS) association is a rare and unusual constellation of nonrandom findings that include Müllerian duct aplasia, renal aplasia, and cervicothoracic somite dysplasia. The agenesis of the Müllerian duct is the second-most common cause of primary amenorrhea after Turner syndrome. The abnormal development of Müllerian duct often associates with the urinary tract and skeletal abnormalities. MURCS association is a unique and rare developmental disorder with four common features of uterine hypoplasia or aplasia, renal agenesis or ectopy, vertebral anomalies, and short stature. Here, we report a 32-year-old female with aplasia of the Müllerian duct, unilateral renal agenesis, and anomalies of the cervicothoracic somites (MURCS association).

Objective: The aim of this study is to evaluate if voiding cystourethrography (VCUG) is necessary for the evaluation of unilateral ectopic pelvic kidney (UEPK) in order to identify vesicoureteral reflux (VUR). Material and methods: Files of the patients who had been followed-up for ectopic pelvic kidney in two pediatric nephrology clinics between August 2011 and December 2017 were retrospectively reviewed. Other anomalies, such as crossed, fused, and bilateral pelvic ectopia were excluded. Preliminary diagnoses were made via urinary ultrasonography while dimercaptosuccinic acid scintigraphy was carried out to confirm the diagnoses. Differential renal function and presence of renal scars was checked. VCUG results were obtained and those patients that showed VUR were noted. Results: A total of 72 patients were included in the study (41 males and 31 females). The median patient age was 4.1 years (range: 2 months-14.5 years). Hydronephrosis was present in only 4 patients (5.6%), where 1 one of those was on the contralateral side. UEPKs contributed to the mean 37.9±7.8% of total renal function and 15% of these patients had renal scars (expressed as a global reduction in function, not as patchy scars). VCUG was obtained in 42 patients and VUR was present in only 1 patient (2.4%). The median follow-up period was 16.5 months (range: 3-92 months). Conclusion: The results of our study indicated that hydronephrosis and VUR are not common in UEPKs. Therefore, routine VCUG should be avoided in the evaluation of UEPK in order to protect patients from unnecessary radiation exposure and an increased risk of urinary tract infections. [ABSTRACT FROM AUTHOR]

Complete renal fusion without crossed renal ectopia denotes the medial fusion of the renal parenchyma (with or without changes in the microarchitecture) in the pelvis with anteriorly placed short ureters terminating into the bladder. This could be due to the failure of renal analgen to ascent, lateral migration, axial rotation, and persistence of primitive vascular supply. Though remain asymptomatic such cases warrant concomitant congenital anomalies of other organ systems as well as the microarchitecture changes in the renal parenchyma. [ABSTRACT FROM AUTHOR]