Presentation
Flank pain
Patient Data
Both kidneys are not present at their normal anatomical location at renal fossa. Pelvic location of kidney is noted with irregular shape and giving off bilateral renal vascular pedicles (both renal veins and arteries), in keeping with ectopic fused both kidneys at the pelvis, known as pancake kidney.
There is visualised renal pelvis facing left with a short ureter that crosses posteriorly draining at the right vesicoureteric junction. It is not possible to adequately assess ureters in the current non-contrast study with empty urinary bladder.
Right seminal vesicle is seen, the left one is not identified in keeping with left seminal vesicle agenesis.
Prominent abdominal azygos vein, posterior to IVC.
Case Discussion
Both kidneys are ectopic and fused at the pelvic region (fused pelvic kidney), giving the characteristic appearance of a "pancake kidney". It is a rare renal fusion anomaly of the crossed fused variety. It is incidentally noted in this case and flank pain is likely no related to renal origin. This is the usual location of pancake kidney anterior to the aortic bifurcation. Seminal vesicle agenesis is an association with renal anomalies.
On current examination, there is only visualised renal pelvis and ureter, which is a more rare variant that has been previously reported in only four patient 1.
Differential diagnosis is solitary ectopic pelvic kidney, but it would have single vascular pedicle.
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