Nephroureterectomy of Right-to-Left Crossed Fused Renal Ectopia with Urothelial Carcinoma

Curēus
Jason HearnMichael Organ

Abstract

Urothelial carcinoma in a crossed fused renal ectopia (CFRE) is an exceedingly rare clinical finding. We describe the surgical management used to treat upper tract urothelial carcinoma in a 64-year-old man with a right-to-left CFRE. Nephroureterectomy with bladder cuff excision was the treatment of choice. The fused kidney was carefully dissected until an area of demarcation emerged between the vasculature supplying the left and right moieties. Pressure was applied to the isthmus separating the two moieties, and a sharp incision was made to release the left moiety. The operation was completed with limited blood loss. Pathology revealed a high-grade T3 papillary urothelial carcinoma with negative margins. To our knowledge, the case is the first to report urothelial carcinoma in a right-to-left CFRE.

References

Feb 1, 1978·The Journal of Urology·F F Marshall, M T Freedman
May 1, 1978·The Journal of Urology·M A RubensteinJ G Bucy
Aug 6, 2003·Critical Reviews in Oncology/hematology·Ziya Kirkali, Emre Tuzel
Oct 11, 2003·Urology·Uri GurJack Baniel
May 22, 2009·AJR. American Journal of Roentgenology·Raghunandan VikramChaan S Ng
May 8, 2010·Nature Reviews. Urology·Wong-Ho ChowSusan S Devesa
Apr 20, 2013·Journal of Indian Association of Pediatric Surgeons·Shailesh SolankiRakesh Kumar
Dec 6, 2017·Journal of Ultrasound·Anna MudoniVitale Nuzzo

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