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Unusual Presentation of Renal Cell Carcinoma in Crossed Ectopic Kidney.

Nowroozi MR, Ghorbani H, Amini E, Arbab A, Ghadian A - Nephrourol Mon (2015)

Bottom Line: The left kidney showed a lump pattern embedded in lower pole of the right kidney.Left sided nephrectomy was performed while temporary right renal artery was clamped temporarily.Histopathological evaluation revealed clear cell carcinoma with severe nuclear atypia (Fuhrman grade 4/4).

View Article: PubMed Central - PubMed

Affiliation: Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.

ABSTRACT

Introduction: Crossed renal ectopia is a rare anomaly and ninety percent of crossed ectopic kidneys are fused to their ipsilateral mate. Based on autopsy findings, the incidence has been estimated to be one in 2000 individuals.

Case presentation: We hereby report on a 53-year-old woman with two episodes of painless gross hematuria. Imaging revealed left side fused crossed renal ectopia and filling defect within the pyelocaliceal of crossed kidney.

Conclusions: The patient underwent surgery applying a midline incision. The left kidney showed a lump pattern embedded in lower pole of the right kidney. Left sided nephrectomy was performed while temporary right renal artery was clamped temporarily. Histopathological evaluation revealed clear cell carcinoma with severe nuclear atypia (Fuhrman grade 4/4). However, local recurrence was not detected during the 18-month follow up after surgery.

No MeSH data available.


Related in: MedlinePlus

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fig19866: IUV and CT of Patient

Mentions: A 53-year-old woman was admitted to our department with two episodes of painless gross hematuria during the last three months. She had no history of systemic diseases, constitutional symptoms and familial history of urological disorders. Physical exam revealed a palpable ill-defined mass in the right upper quadrant with extension to the umbilical region. Serum creatinine was 1.4 mg/dL, and urine analysis revealed microscopic hematuria (20-25 RBC / HPF). Urine cytology was negative for malignancy. Intravenous Urography (IVU) revealed left side fused crossed renal ectopia and filling defect within the pelvis of the crossed kidney (Figure 1 A). A filling defect was evident in the left crossed fused kidney in retrograde pyelography (Figure 1 A). Computerized-tomography (CT) scan confirmed the presence of left crossed renal ectopia associated with an enhancing mass, arising from the pelvis and pyelocaliceal system of the crossed kidney (Figure 1 C, 1D). Cystoscopy showed no abnormality within the bladder. Ureteral orifices were normal. Chest X-ray and liver function tests were normal. The patient underwent surgery applying a midline incision. Left kidney showed a lump pattern, embedded in the lower pole of the right kidney. Both pelvises of kidneys were located anteriorly. Left renal pelvis and parapelvis tissue were firm.


Unusual Presentation of Renal Cell Carcinoma in Crossed Ectopic Kidney.

Nowroozi MR, Ghorbani H, Amini E, Arbab A, Ghadian A - Nephrourol Mon (2015)

IUV and CT of Patient
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4537599&req=5

fig19866: IUV and CT of Patient
Mentions: A 53-year-old woman was admitted to our department with two episodes of painless gross hematuria during the last three months. She had no history of systemic diseases, constitutional symptoms and familial history of urological disorders. Physical exam revealed a palpable ill-defined mass in the right upper quadrant with extension to the umbilical region. Serum creatinine was 1.4 mg/dL, and urine analysis revealed microscopic hematuria (20-25 RBC / HPF). Urine cytology was negative for malignancy. Intravenous Urography (IVU) revealed left side fused crossed renal ectopia and filling defect within the pelvis of the crossed kidney (Figure 1 A). A filling defect was evident in the left crossed fused kidney in retrograde pyelography (Figure 1 A). Computerized-tomography (CT) scan confirmed the presence of left crossed renal ectopia associated with an enhancing mass, arising from the pelvis and pyelocaliceal system of the crossed kidney (Figure 1 C, 1D). Cystoscopy showed no abnormality within the bladder. Ureteral orifices were normal. Chest X-ray and liver function tests were normal. The patient underwent surgery applying a midline incision. Left kidney showed a lump pattern, embedded in the lower pole of the right kidney. Both pelvises of kidneys were located anteriorly. Left renal pelvis and parapelvis tissue were firm.

Bottom Line: The left kidney showed a lump pattern embedded in lower pole of the right kidney.Left sided nephrectomy was performed while temporary right renal artery was clamped temporarily.Histopathological evaluation revealed clear cell carcinoma with severe nuclear atypia (Fuhrman grade 4/4).

View Article: PubMed Central - PubMed

Affiliation: Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.

ABSTRACT

Introduction: Crossed renal ectopia is a rare anomaly and ninety percent of crossed ectopic kidneys are fused to their ipsilateral mate. Based on autopsy findings, the incidence has been estimated to be one in 2000 individuals.

Case presentation: We hereby report on a 53-year-old woman with two episodes of painless gross hematuria. Imaging revealed left side fused crossed renal ectopia and filling defect within the pyelocaliceal of crossed kidney.

Conclusions: The patient underwent surgery applying a midline incision. The left kidney showed a lump pattern embedded in lower pole of the right kidney. Left sided nephrectomy was performed while temporary right renal artery was clamped temporarily. Histopathological evaluation revealed clear cell carcinoma with severe nuclear atypia (Fuhrman grade 4/4). However, local recurrence was not detected during the 18-month follow up after surgery.

No MeSH data available.


Related in: MedlinePlus