A Dilemmic Case of Left to Right Crossed Fused Renal Ectopia Reported as Solitary Kidney with Renal Cyst: A Rare Case Report

Gideon M, Mathew G and Rajendran R*

Department of Urology, Amrita Institute of Medical Sciences, India

^*Correspondance to: Rohan Rajendran 

 PDF  Full Text DOI: 10.25107/2474-1647.3645

Abstract

A 46-year-old male with history of hemoptysis was evaluated with ultrasound showing solitary right kidney with hydroureteronephrosis. CT IVU showed Crossed fused left to right renal ectopia with gross HUN of left kidney and moderate HUN of right kidney. Creatinine was 1.55 in January 2022. Patient was totally asymptomatic. CT done here in AIMS Kochi showed single right kidney with moderate HUN. Large cystic lesion in relation to lower pole of right kidney reaching up to pelvis which could be urinoma or large renal cyst. This cystic lesion was seen compressing the mid/ distal right ureter causing HUN. Cystoscopy was done first during surgery. Retrograde Pyelogram (RGP) on the left side showed Left ureteric orifice. Guidewire seen to be coiled at some distance. RGP showed? dilated pelvis? Cyst with some contrast at the base of the enlarged moiety. Right side RGP showed moderate to severe HUN.USG guided fluid aspiration was done before surgery. Approximately 350 ml of brownish thick fluid was aspirated out to relieve the mass effect before surgery. Fluid was sent for creatinine which came to be 3.11. Intraoperatively huge cystic moiety noted at the lower pole of right kidney which was separated from the surrounding tissues. One vessel? Renal vein of left side was clipped and divided. Cystic moiety was incised and the fluid was sucked out. Part of the moiety which was adhered to the lower pole was not separable so remaining moiety was cut and excised and the area at the lower pole was cauterized and surgical was placed over it. Postoperatively creatinine trend was like 1.91-1.76-1.66-1.55. Follow up USG showed Right gross HUN. Creatinine on follow up after one month was 1.5. Biopsy of the specimen showed Left renal mass - Features suggestive of Hydronephrosis

Keywords

Cite the article

Gideon M, Mathew G, Rajendran R. A Dilemmic Case of Left to Right Crossed Fused Renal Ectopia Reported as Solitary Kidney with Renal Cyst: A Rare Case Report. Clin Surg. 2023; 8: 3645..