Presentation
Recurrent urinary tract infection.
Patient Data
Both kidneys are malrotated, fused at their lower poles forming a parenchymal bridge (isthmus) crossing the midline anterior to the aorta and IVC at L3-4 level. Mild dilatation of the right renal cavities and ureter. No renal or ureteral stone was seen.
Other findings:
Small well-defined ovoid hypodense right adrenal mass of homogeneous density. The mean attenuation value on non-contrast CT was around -12 HU, suggestive of adrenal adenoma
degenerative lumbar spine with scoliosis of left-sided convexity
Case Discussion
CT features of horseshoe kidney.
Horseshoe kidney is considered the most common type of renal fusion anomaly. On imaging, especially on ultrasound, the parenchymal isthmus crossing the midline anterior to the aorta and IVC should not be mistaken for a midline retroperitoneal mass such as lymphoma or metastatic lymphadenopathy.