Right supernumerary kidney with urothelial carcinoma

Abstract

Rationale: A supernumerary kidney is an extremely rare renal anomaly. Currently, <100 cases are reported in the literature. There are only 2 right unilateral supernumerary kidneys reported in the literature thus far, but no confirmed cases of urothelial carcinoma in supernumerary kidneys. We report a case of a right supernumerary with urothelial carcinoma, which is, to the best of our knowledge, reported for the first time. Patient concerns: A 73-year-old female patient presented with intermittent, painless, whole course and gross hematuria for about 3 months. Her physical and laboratory examinations did not reveal any significant findings except positive occult blood in routine urine examination. Contrast-enhanced spiral computed tomography revealed a dysplastic supernumerary kidney under the normal right kidney. Diagnoses: The ureteroscopy showed that the ureter was Y-shaped in the middle part. The medial ureter led to a normal kidney. The lateral ureter was just 2 cm and led to a small cavity in which there was a mass whose biopsy showed urothelial carcinoma. The patient was subsequently diagnosed with a right supernumerary kidney with urothelial carcinoma. Intervention: Nephroureterectomy, including the right normal and supernumerary kidneys, and partial cystectomy by laparoscopy were performed after the ureteroscopy. The patient then received 6 cycles of gemcitabine and cisplatin regimen chemotherapy and regular intravesical epirubicin chemotherapy. Outcomes: No recurrence or metastasis was found on follow-up computed tomography performed 13 months postoperatively. Lessons: A supernumerary kidney is an extremely rare renal anomaly. Malignancy can occur in supernumerary kidneys.

Bilaterally Fused Supernumerary Kidneys: A Very Rare Case Report and Review of Literature

“…When SNK is located caudally, a bifid ureter is seen often and the common site of fusion is usually near the bladder. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] The Weigert-Meyer rule may be followed in SNKs with ectopically located ureteric orifices during entry into the bladder but rare reports of opening near the vagina, cervix, prostatic urethra and vulva also exist. 18 The embryological development of SNK has been debated in the literature.…”

“…Most cases of SNK have appeared as a surprise to the surgeon. 5,8,9 Preoperative diagnosis of SNK has been reported in few cases using imaging modalities such as Intravenous Urography (IVU), CT scan, radionuclide imaging, and magnetic resonance imaging (MRI). However, the diagnostic yield of some of these imaging modalities such as IVU will entirely depend on the functionality of the SNK.…”

“…Occasionally however, SNKs may present with symptoms during childhood or early adulthood due to calculi, tumors, or infections. 1,2,8 SNKs are also easily missed during cross-sectional imaging due to the fact that the supernumerary unit is often small, dysplastic, and non-enhancing. According to Geisinger, the supernumerary unit may be completely distinct from the native kidney or very rarely fused to it by loose connective tissue.…”

Supernumerary Kidney with S-shaped Fusion Anomaly: A Rare Congenital Renal Anomaly

“…Supernumerary kidneys are rare congenital renal anomalies, most of which are detected incidentally and are associated with other congenital anomalies and complications like urinary stasis, hydronephrosis, calculus and pyonephrosis [1]. A few cases were also associated with renal cancers in the native as well as supernumerary kidneys [2]. With increasing number of transplants in today's time, it is important to understand the imaging characteristics and embryogenesis of this rare entity.…”