Right-Crossed, Fused Renal Ectopia L-Shaped Kidney Type with Urinary Chyluria

Abstract

Crossed fused renal ectopia combined with chyluria is extremely rare. Here we report the case of a patient who was admitted to our institution since milky urine and was finally found to have an L-shaped fused kidney and renal pelvis fistula. The patient was cured by renal pelvic instillation sclerotherapy.

Case Report of a Pelvic Crossed Fused Renal Ectopic Kidney

“…CFRE is a relatively uncommon congenital kidney anomaly with an incidence at autopsy of 1 in 2000 [1,2]. According to Liu et al, CFRE occurs up to two times more often in men than in women, and more often on the right side [3]. In the present case, the fused kidney was mostly located on the left side, and the right kidney was on the midline.…”

“…CFRE is the second most common fusion anomaly of the kidney. There are six unique types of CFRE that have been identified to date: inferior crossed fused ectopia, sigmoid or S-shaped kidney, lump kidney, disc kidney, L-shaped kidney, and superior crossed fused ectopia [3]. The present case was the inferior crossed fused ectopia.…”

“…These anomalies can be diagnosed using computed tomography and magnetic resonance images, but may also could be overlooked if knowledge of variants is lacking. Patients presenting with CFRE are often asymptomatic, but they sometimes report the following varied symptoms: flank pain, urolithiasis, abdominal pain, blood in the urine, no creation of urine, frequent urinary tract infections, renal failure, fever, hydronephrosis, and high blood pressure [3]. Also, a CFRE could be misdiagnosed as an abdominal mass [6].…”

“…In patients with CFRE, there is a lack of fusion and lack of complete rotation. It is important to note that CFRE may lead to fistula formation between the collecting ducts and the lymphatics and can present as milky-colored urine [3].…”

Coexistence of a rare type of ectopic kidney with atypical renal vasculature

“…The ureter of the ectopic kidney in all types of fused kidneys crosses the midline. (Decter 1997;Yin et al 2014;Liu et al 2015) The least common is 'cake' kidney, which occurs in 2% of renal fusion cases. It is a complete fusion of kidneys in which ureters do not cross the midline.…”