Solares-Sánchez ME, Cortés-Flores AO, Cano-Valdez AM, Martínez-Cervera PF, Jiménez-Ríos MÁ

Language: Spanish
References: 12
Page: 314-318
PDF size: 618.95 Kb.

ABSTRACT

Congenital simple ectopia refers to a low-situated kidney that did not ascend normally and that can be located either at the edge of or within the pelvis. This type of kidney usually receives its blood flow from adjacent vessels and has a short ureter. Patients remain asymptomatic until adulthood, when they present with urinary infection, urolithiasis, and abdominal mass or pain.
A 39-year-old man had a 2-month history of pain in the right flank that irradiated to the hypogastrium. Abdominal ultrasound revealed the absence of the right kidney at its normal topography and a solid tumor with heterogeneous echogenicity. Tomography scan reported the absence of the right kidney in its anatomic position and a solid 12 x 10 cm mass at the pelvic level. Palliative surgical treatment was decided upon and the patient underwent exploratory laparotomy resulting in the following findings: right kidney located at the retroperitoneal pelvic level with a tumor of approximately 12 x 10 cm that was dependent on the upper pole.
The anomalies of renal fusion and ectopia associated with cancer are rare clinical situations and thus represent a diagnostic and therapeutic challenge. The most common histologic type reported in these cases is conventional renal cell carcinoma, but with no greater incidence than that found in the general population. Radical nephrectomy is recommended as the main therapeutic option and a laparoscopic approach can also be considered.

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