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Metastatic prostate cancer in a patient with crossed fused renal ectopia

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Poor urinary stream and elevated Prostate Specific Antigen.

Patient Data

Age: 60 years
Gender: Male

The left kidney has crossed the midline and lies on the right side, inferomedial to the right kidney and fused to the lower pole inferring crossed fused renal ectopia.

The prostate gland is markedly enlarged and shows inhomogeneous enhancement that seems to infiltrate the base of the urinary bladder.

Several lymphadenopathy are present at both parailiac and right inguinal regions with SAD less than 24 mm. In addition, lymphadenopathy with SAD of 11 mm is noted in the lower para aortic region. 

Osteoblastic lesions are seen in the thoracolumbar spine and bony pelvis.

Several stones are noted in the gallbladder.

Case Discussion

Pathology proved prostate adenocarcinoma with infiltration of the urinary bladder base. Parailiac, inguinal, and distal para aortic lymphadenopathy and diffuse osseous metastases.

There is also crossed fused renal ectopia which refers to a congenital anomaly where the kidneys are fused and located on the same side of the midline.

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