Cao Yalei, Zhang Yinan, Kang Weiting, Suo Ning, Cui Zilian, Luo Yuanman, Jin Xunbo
Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.
Medicine (Baltimore). 2019 Nov;98(48):e18165. doi: 10.1097/MD.0000000000018165.
Crossed renal ectopia (CRE) is a rare congenital anomaly that is frequently associated with gastrointestinal, cardiovascular, genital and bone malformations. To the best of our knowledge, only 35 cases of crossed renal ectopia involving calculi and 30 cases of CRE associated with renal carcinoma have been reported to date.
Here, we present 2 cases of crossed renal ectopia. A 59-year-old woman with diabetes presented to our hospital with abdominal pain. The second patient was a 24-year-old woman who complained with abdominal pain with a duration of 1 day.
On the basis of abdominal ultrasonography, we suspected a solitary kidney both in the two patients. Combined with retrograde pyelography and 3D computed tomography, case 1 was diagnosed as an S-shaped right-to-left crossed-fused ectopic kidney with many stones in the left (normal) renal pelvis and case 2 was confirmed to have lump right-to-left crossed-fused renal ectopia with two 3-mm stones in the renal pelvis of the 2 kidneys.
Case 1 underwent percutaneous nephrolithotomy while case 2 refused to undergo surgery and underwent conservative treatment for pain relief.
Two patients have been followed up and have no stones recurrence.
Crossed fused renal ectopia is easily misdiagnosed as a solitary kidney. CRE is so rare that the recognition of the disease needs to be improved and effective treatment should be taken timely. According to the two cases and literature review, minimally invasive surgery has become increasingly common to treat CRE with stones and carcinoma.
交叉异位肾(CRE)是一种罕见的先天性异常,常与胃肠道、心血管、生殖和骨骼畸形相关。据我们所知,迄今为止,仅报道了35例涉及结石的交叉异位肾病例和30例与肾癌相关的交叉异位肾病例。
在此,我们报告2例交叉异位肾病例。一名59岁的糖尿病女性因腹痛前来我院就诊。第二名患者是一名24岁女性,主诉腹痛1天。
根据腹部超声检查,我们怀疑这两名患者均为孤立肾。结合逆行肾盂造影和三维计算机断层扫描,病例1被诊断为S形右向左交叉融合异位肾,左(正常)肾盂内有许多结石;病例2被确诊为块状右向左交叉融合异位肾,双肾肾盂内有两颗3毫米结石。
病例1接受了经皮肾镜取石术,而病例2拒绝手术,接受了止痛的保守治疗。
两名患者均得到随访,结石无复发。
交叉融合异位肾容易被误诊为孤立肾。交叉异位肾非常罕见,对该疾病的认识需要提高,应及时采取有效的治疗措施。根据这两个病例及文献回顾,微创手术已越来越普遍地用于治疗伴有结石和癌症的交叉异位肾。