Renal Cell Carcinoma in a Horseshoe Kidney: Radiology and Pathology Correlation

Abstract

Renal cell carcinoma (RCC) is encountered in about 3% of all adult neoplasms. Presence of any kidney malformation can change the plan for surgical treatment of RCC with organ preserving surgery. We report a case of clear cell RCC in a horseshoe kidney. Computed tomography scan revealed a horseshoe kidney anomaly with a large mass in the left side. The diagnosis of RCC was confirmed by pathology and histology findings.

A Rare Case of a Renal Cell Carcinoma Confined to the Isthmus of a Horseshoe Kidney

“…Horseshoe kidney is the most common renal fusion anomaly and more common in males than in females [ 2 , 5 ]. HSKs are usually asymptomatic and are often incidentally discovered during physical exam or seen on imaging studies; when symptomatic, they are associated with hydronephrosis, infection, or calculus formation [ 2 , 6 ]. When located at the isthmus, these can mimic intra-abdominal disease processes like aortic abdominal aneurysm or ovarian tumors [ 2 , 7 , 8 ].…”

“…It is not clear if the incidence of RCC in HSK patients is increased compared to non-HSK individuals, as there are conflicting reports in the literature [ 2 , 4 , 5 ]. Our patient presented with RCC of the isthmus of an HSK, with less than ten reported cases, per our literature search using search words like HSK tumors, isthmus tumors, and HSK complications.…”

“…Horseshoe kidney (HSK) occurs in 3% of the population and is the most common renal fusion anomaly [ 1 – 4 ]. There are conflicting reports as to whether or not there is an increase incidence of renal tumors in HSK compared to the normal population [ 2 , 4 , 5 ]. There however have been very few reported cases of RCC located at the isthmus of an HSK per our literature search.…”

Pediatric Papillary Renal Cell Carcinoma in a Horseshoe Kidney: A Case Report with Review of the Literature

“…Horseshoe kidney is the most common type of renal fusion anomaly; it occurs in 1 per 400–600 live births and is twice as common in males as in females [ 7 ]. Horseshoe kidney consists of two distinct functioning kidneys on each side of the midline, connected at the lower poles by an isthmus of functioning renal parenchyma or fibrous tissue that crosses the midline of the body [ 8 ]. Almost one-third of all patients with horseshoe kidney remain asymptomatic, only being diagnosed incidentally during physical examination or by CT scans [ 9 ].…”

Horseshoe kidney mimicking cross-fused ectopia on 99m Tc-EC renal dynamic scintigraphy

“…[ 2 ] Intravenous urography (IVU), computed tomography (CT) scanning, magnetic resonance imaging (MRI), and scintigraphy depict horseshoe kidney with a high degree of accuracy. [ 3 4 ] Scintigraphy plays an important role for determining function and drainage pattern of moieties. On imaging differentiation between horseshoe kidney and crossed fused ectopia may not always be possible.…”