Ectopic thoracic kidney

Case contributed by Dr Mariela Sosa Ramos

Presentation

Four days of productive cough.

Patient Data

Age: 2 months
Gender: Male
X-ray

The radiopaque image is shown in the right hemithorax with an oval tendency, without air bronchogram or silhouette sing at the right lung base. The same image is located posterior to the cardiac silhouette on the lateral projection.

CT

Intrathoracic right kidney, through a posterior defect at right hemidiaphragm. Note the normal anatomical origin of the right renal artery.

The left kidney is of normal anatomical location in the renal fossa.

Case Discussion

This patient has a medical history of cough and grades III gastroesophageal reflux. At the time of its evaluation, the use of intercostal and subcostal muscles was identified auscultating a diminished vesicular murmur with the right predominance.

When performing a chest X-ray, a hyperdense image with an oval tendency was observed with no evidence of air bronchogram and because the treating service did not coincide, it decided the complement which showed of a mass visualized in the right lung, was a kidney.

Renal intrathoracic ectopia denotes a complete or partial protrusion of the kidney above the level diaphragm into the posterior mediastinum. It is more common in men than in women. It is generally asymptomatic but, those with gestational cough could be misdiagnosed as a mass or pleural effusion on chest radiographs as in the case of the patient.

Ectopic kidney may be pelvic, iliac, thoracic, contralateral or crossed. Initially located in the pelvis, they migrate cranially such that by the third month they are at the level of the L2 vertebra and meet the suprarenal glands.

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Case information

rID: 80231
Published: 27th Jul 2020
Last edited: 28th Jul 2020
System: Urogenital, Chest
Inclusion in quiz mode: Included