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Solitary crossed renal ectopia

Case contributed by Mahmoud Agha
Diagnosis certain

Presentation

Persistent unexplained right loin pain.

Patient Data

Age: 25 years
Gender: Male

CT urography

ct

Missing right kidney; completely absent (agenetic).

Crossed ectopic left kidney to the right lower lumbar region.

 At the arterial phase:  

  • aortic anomalous high trifurcation, with end level opposite LV2, before the renal artery origin  
  • the aorta ends in three divisions; right and left iliac arteries and one ectopic kidney renal artery
  • a second renal artery is seen originating from the right iliac artery, which is significantly displaced forward by the ectopic solitary kidney
  • double renal veins ending at the left side of the IVC, which supports the fact of left sided renal origin

At the excretory phase:

  • the ureter of the ectopic left kidney crossed midline back to end at the position of the left vesicoureteric orifice
  • associated left renal double moiety and grade I hydronephrosis (likely positional)

Conclusion:

Solitary left renal crossed ectopia (SCRE).

Case Discussion

Solitary crossed renal ectopia (SCRE) is an uncommon congenital abnormality that occurs due to a combination of unilateral renal agenesis and renal ectopiaMcDonald and McClellan classified renal ectopia into four types:

  1. crossed renal ectopia with fusion
  2. crossed renal ectopia without fusion
  3. solitary crossed renal ectopia
  4. bilaterally crossed renal ectopia

Only 34 patients of SCRE has been reported in the literature until date 1,2.

Case contributions from Dr Amro Saadawy; Lecturer of diagnostic imaging. Ein Shams University, Egypt.

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