Presentation
Periumbilical pain and known umbilical hernia.
Patient Data
Hypoenhancing, partially exophytic mass arising from the superior right moiety of the horseshoe kidney with tumor thrombus extending into the right renal vein, proximal portion of the left renal vein, and inferior vena cava (IVC). Bland thrombus in the infrarenal IVC extending into the common iliac veins.
Bilateral adrenal nodules concerning for metastases.
Minimal intraperitoneal effusion is noted.
Partially visualized pulmonary emboli are seen in the lung bases.
Case Discussion
Pathology: Renal cell carcinoma, papillary type, Fuhrman grade 2, with extension into the IVC.
Horseshoe kidney is the most common renal fusion anomaly.
Incidence 0.4-1.6 in 10,000 live births, males > females
Associated with an increased risk of Wilms tumor, transitional cell carcinoma, and primary renal carcinoid tumors (62x).
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