Presentation
Asymptomatic. Patient came for screening and incidental finding of renal ectopia in ultrasonography for which she was planned CT urography.
Patient Data
Right to left crossed fused renal ectopia is seen with upper pole of right ectopic kidney fusing with lower pole of left kidney. Left kidney is supplied by left renal artery arising from aorta and right kidney is supplied by left common iliac artery near its bifurcation from aorta. Left renal vein is draining into IVC. Right renal vein is draining into IVC near its bifurcation. Renal pelvis of both kidneys is directed anterolaterally. Both kidneys show prompt contrast enhancement and excretion. Pelvicalyceal system not dilated. No calculus seen. A well defined non enhancing fluid attenuation lesion with thin imperceptible wall measuring approximately 6 mm x 6 mm is seen in the upper pole. No calcification, septations, enhancing solid components seen. Both ureters are inserting into their orthotropic position.
Impression:
- Normal excreting both kidneys.
- Right to left crossed fused renal ectopia.
- Left renal cortical cyst (Bosniak I).
Case Discussion
Crossed fused renal ectopia is a rare congenital abnormality of the renal system where there is crossing over of one kidney to opposite side and fusion of renal parenchyma takes place. Although, left to right ectopia is three times common, here we have presented a case of right to left inferior crossed fused renal ectopia. Patients are usually asymptomatic and usually are diagnosed incidentally. However, there is increased probability of formation of nephrolithiasis in these patient.
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