Surgical Management of Ectopic Kidney with Bilateral Iliac Vein Invasion

Surgical management of a locally invasive renal cell carcinoma in an ectopic pelvic kidney

The coincidence of renal cell carcinoma in an ectopic kidney is a unique phenomenon. We report a case of 55 years old male patient who presented with backache and accidentally discovered ectopic kidney with an upper polar mass. Preoperative assessment was done with pelviabdominal sonography and triphasic renal CT. Our patient underwent radical nephrectomy through a midline incision with unexpected vasculature encountered intraoperatively. According to our knowledge, only eight cases of pelvic kidney tumors have been reported in the literature and this case is unique with its complex vascular structure.

Renal cell carcinoma in a lumbar ectopic kidney

Introduction

Lumbar ectopic kidney is a rare developmental renal anomaly. We report a case of renal cell carcinoma in lumbar ectopic kidney with an abnormality of the main renal artery piercing the renal parenchyma.

Case presentation

A 70‐year‐old female was referred to our division with an incidentally diagnosed ectopic kidney. Computed tomography angiography detected the right kidney at the lumbar (L3‐L4) level with an early‐enhanced 44‐mm‐diameter mass. The kidney had a laterally facing renal hilum and renal arteries piercing the renal parenchyma from the medial side. An open radical nephrectomy was performed using a peritoneal approach, and no perioperative complications were observed. The pathological diagnosis was clear cell carcinoma (pT1).

Conclusion

This is the first case report of renal cell carcinoma in a lumbar ectopic kidney. It highlights the importance of preoperational imaging for aberrant artery and careful surgical management.

Renal cell carcinoma in ectopic-pelvic kidney: A rare case with review of literature

The incidence of renal cell carcinoma in a pelvic kidney is rare, and has only been reported in a small number of cases. We report a 50-year-old male patient presented with vague abdominal pain and without hematuria. CT scan showed large heterogeneous soft tissue mass arising from a left pelvic kidney with areas of necrosis measuring 8.4×8.4×7.5 cm. Histopathology after radical nephro-ureterectomy showed grade II clear-cell renal carcinoma. Renal cell carcinoma of ectopic kidney is a rare disease. Even though the presentation might be atypical and challenging, the treatment strategy is still the same as for tumors of orthotopic kidneys.