A 52-year-old woman presented with right loin pain and haematuria of 2 months' duration. A clinical examination was unremarkable, but on CT there was an enhancing large heterogeneous mass in the right kidney and another distinct smaller mass of similar CT characteristics inferior to the right kidney ( Fig. 1). The masses did not appear contiguous in any of the CT sections. Exploration disclosed a large tumour in the right kidney and inferiorly a separate smaller reniform mass with tumefaction, with all the features of a supernumerary kidney, e.g. a distinct blood supply and ureter (Fig. 2). Both units were extirpated radically; histologically both had the granular cell variant of RCC (nuclear grade III).
CommentsThe supernumerary kidney is a very rare anomaly of the urinary system; the confirming criteria are a separate collecting system, blood supply and distinct and encapsulated parenchymal mass [1]. Malignancy in a supernumerary kidney is extremely rare. Although Wilms' tumour and cystadenocarcinoma have been described in supernumerary kidneys [2,3] to date no case of RCC has been reported. Thus the synchronous occurrence of RCC in supernumerary and ipsilateral kidneys as reported here is of interest because it is extremely rare.
References1 Sasidharan K, Babu AS, Rao MM, Bhat HS. Free supernumerary kidney. Br J Urol 1976; 48 : 388 2 Wu JP, Garcia J. Supernumerary kidney with Wilms' tumor.Fig. 1. CT showing RCC in the right kidney and in the ipsilateral supernumerary kidney.Fig. 2. The transected specimens of the tumour-containing right kidney and ipsilateral supernumerary kidney.