Renal Ectopia

  • 文章类型: Case Reports
    交叉融合肾异位(CFRE)是一种罕见的先天性异常,其中肾脏位于输尿管连接膀胱的另一侧,合并到另一个肾脏.它与其他罕见的先天性畸形有关,包括VACTERL协会(椎骨异常,肛门闭锁,心脏异常,气管食管瘘,食管闭锁,肾脏异常,和肢体异常),MURCS协会(穆勒导管,肾,和颈胸脊柱异常),感染率增加,阻塞,囊性发育不良,还有尿石症.尽管文献仅记录了少数CFRE与瘤形成同时发生的病例,我们介绍了一例59岁的患者,其右侧异位肾与左侧异位肾融合,同时发生原发性肾细胞癌。我们的目的是报告和讨论这个病例和治疗方法,将其与现有文献进行比较,以增强我们对类似事件的理解和管理,由于这些病例具有挑战性的解剖结构,部分肾切除术并不常见。
    Crossed fused renal ectopia (CFRE) is a rare congenital anomaly in which a kidney is located on the opposite side from where its ureter connects to the bladder, merging into the other kidney. It has been linked to other rare congenital malformations, including the VACTERL association (vertebral anomalies, anal atresia, cardiac anomalies, tracheoesophageal fistula, esophageal atresia, renal anomalies, and limb abnormalities), the MURCS association (müllerian ducts, renal, and cervicothoracic spine anomalies), increased incidence of infections, obstruction, cystic dysplasia, and urolithiasis. Although the literature has documented only a small number of cases wherein CFRE coincides with neoplasia, we present the case of a 59-year-old patient with a right ectopic kidney fused to the left one and simultaneous primary renal cell carcinoma. We aim to report and discuss this case and the treatment approach, comparing it with existing literature to enhance our understanding and management of similar occurrences, as partial nephrectomy is uncommon due to the challenging anatomy of these cases.
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  • 文章类型: Case Reports
    肾异位,一种罕见的先天性异常,可能发生在不同的身体区域,并可能与其他异常有关。它通常是无症状的,常见的偶然发现,就像我们70岁的病人在阑尾炎探查时一样。该病例强调了认识肾异位和相关异常的重要性,如血管异常和肾脏旋转不良,这可能会使患者容易发生潜在的并发症,并需要警惕监测尿路感染和结石事件,以及腹腔镜手术期间的潜在挑战,就像我们的阑尾切除术一样.
    方法:一名70岁女性患者出现右髂窝疼痛和炎症标志物升高。腹盆腔CT扫描证实无并发症阑尾炎,并显示正确的异位和旋转不良的肾脏。腹腔镜阑尾切除术无并发症。术后恢复顺利,出院发生在术后一天。计划进行为期四周的随访,以监测尿路感染和结石形成,开始卫生和饮食措施。
    肾异位,先天性异常,经常将肾脏定位在骨盆区域。Ilic异位常与盆腔或腹部异位混淆。异位肾脏会导致并发症,如膀胱输尿管反流,尿路感染,或者肾结石.尽管通常是左边的,我们的患者出现右侧肾脏异位伴旋转不良。尽管没有泌尿症状,由于存在感染或肾结石的潜在风险,建议进行泌尿外科咨询。手术干预保留用于并发症管理。
    结论:肾异位,一种罕见的先天性异常,可以无症状,但通常与其他肾脏或血管问题一致。早期检测和准确成像至关重要,强调临床警惕和跨学科合作,以改善患者护理。
    UNASSIGNED: Renal ectopia, a rare congenital anomaly, can occur in various body regions and may be associated with other abnormalities. It is often asymptomatic, commonly found incidentally, as in our 70-year-old patient during appendicitis exploration. This case highlights the importance of recognizing renal ectopia and associated anomalies, such as vascular abnormalities and renal malrotation, which may predispose patients to potential complications and require vigilant monitoring for urinary tract infections and lithiasis events, as well as potential challenges during laparoscopic surgical procedures, as in our appendectomy case.
    METHODS: A 70-year-old female presented with right iliac fossa pain and elevated inflammatory markers. Abdominopelvic CT scan confirmed uncomplicated appendicitis and revealed a right ectopic and malrotated kidney. Laparoscopic appendectomy was performed without complications. Postoperative recovery was uneventful, and discharge occurred one day post-procedure. A four-week follow-up was scheduled to monitor for urinary infection and stone formation, with initiation of hygienic and dietary measures.
    UNASSIGNED: Renal ectopia, a congenital anomaly, frequently positions the kidneys in the pelvic region. Iliac ectopias are often confused with pelvic or abdominal ectopias. Ectopic kidneys can result in complications like vesicoureteral reflux, urinary tract infections, or kidney stones. Despite being typically left-sided, our patient presented with right-sided renal ectopia with malrotation. Despite lacking urinary symptoms, a urological consultation was advised due to the potential risk of infection or kidney stones. Surgical intervention is reserved for complication management.
    CONCLUSIONS: Renal ectopia, a rare congenital anomaly, can be asymptomatic but often coincides with other renal or vascular issues. Early detection and accurate imaging are essential, emphasizing clinical vigilance and interdisciplinary collaboration for better patient care.
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  • 文章类型: Case Reports
    很少发生在出生时,交叉肾异位是一种异常,其中两个肾脏占据身体的同一侧,而一个输尿管-其长度基于肾脏位置-穿过中线以移植到相对侧的膀胱中。McDonald和McClellan将肾异位分为4种类型。孤立性交叉肾异位(SCRE)是泌尿系统极为罕见的异常。迄今为止,在已发表的文献中仅记录了35例。通常,这些病例是在患者评估相关问题(如泌尿生殖系统)时偶然发现的,心血管,血液学或椎骨异常。
    Rarely occurring at birth, crossed renal ectopia is an abnormality in which both kidneys occupy the same side of the body while one ureter - its length based on kidney location - traverses across midline to graft into opposite-side bladder. McDonald and McClellan classified renal ectopia into 4 types. Solitary crossed renal ectopia (SCRE) is an extremely uncommon abnormality of the urinary system. To date, only 35 instances have been documented in published literature. Typically, these cases are detected by chance during patient assessments for related issues such as genitourinary, cardiovascular, hematological or vertebral abnormalities.
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  • 文章类型: Journal Article
    本报告探讨了肾脏和泌尿道(CAKUT)的先天性异常的多样性,从无症状表现到以双侧肾脏发育不全为特征的最严重形式。泌尿生殖系统异常,这个领域中的一个普遍子集,占了相当大的比例,构成产前筛查中发现的异常的15-20%。异位肾脏的定义是空肾窝的存在以及肾脏从腰椎区域到其他位置的移位,骨盆区域成为最普遍的部位。报告的病例涉及双侧肾脏异位伴单侧双重肾脏。最初怀疑肾脏异常是在妊娠早期,导致在妊娠中期明确诊断。病人每四周进行一次定期监测,最终在足月分娩一个健康的婴儿。这个病例强调了肾脏异常的频率,强调相当大比例仍然无症状。这些发现有助于更广泛地了解先天性肾脏异常,他们各种各样的表现,以及警惕产前筛查对早期发现和管理的重要性。
    This report explores the diverse spectrum of congenital anomalies of the kidney and urinary tract (CAKUT), ranging from asymptomatic presentations to the most severe form characterized by bilateral renal agenesis. Genitourinary anomalies, a prevalent subset within this domain, account for a significant proportion, constituting 15-20% of anomalies identified during prenatal screening. An ectopic kidney is defined by the presence of an empty renal fossa and the displacement of the kidney from the lumbar region to alternative locations, with the pelvic region emerging as the most prevalent site. The reported case involves bilateral renal ectopia with unilateral duplex kidney. Initial suspicions of a renal anomaly arose during the first trimester, leading to a definitive diagnosis in the second trimester. The patient underwent regular monitoring every four weeks, ultimately delivering a healthy baby at term. This case underscores the frequency of renal anomalies, emphasizing that a considerable proportion remains asymptomatic. These findings contribute to a broader understanding of congenital renal anomalies, their varied manifestations, and the importance of vigilant prenatal screening for early detection and management.
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  • 文章类型: Case Reports
    肾母细胞瘤是儿童中最常见的肾脏恶性肿瘤。已经报道了具有各种先天性泌尿生殖系统异常的Wilms肿瘤的发生。特别是在马蹄形肾脏中,尿道下裂,性发育障碍,双收集系统。然而,肾母细胞瘤与交叉肾外翻是一个罕见的发现。
    我们正在报告一例3岁女孩的Wilms肿瘤,该女孩表现为巨大的左侧包块,并伴有交叉融合的肾脏异位。在胸部的初始检查和三相计算机断层扫描扫描之后,腹部,和骨盆确认诊断和转移,患者接受了图像引导的组织活检,接下来是新辅助化疗,左根治性肾切除术,融合右异位肾部分分离,和辅助化学放射。
    本报告显示Wilms肿瘤与交叉融合肾异位有关,罕见的组合。对于这种罕见的发现,应将单侧侧腹肿块的影像学异常发现视为鉴别诊断的一部分。辅助化疗和现代成像有助于描绘解剖结构并简化手术,以实现安全切除,改善整体结果。
    UNASSIGNED: Wilms tumor is the most common renal malignancy in children. The occurrence of Wilms tumor with various congenital genitourinary anomalies has been reported, particularly in horseshoe kidneys, hypospadias, disorder of sexual development, and double collecting system. However, Wilms tumor with crossed renal ectopia is a rare finding.
    UNASSIGNED: We are reporting a case report of Wilms tumor in a 3-year-old girl who presented with a huge left flank mass with cross-fused renal ectopia. After the initial workup and triphasic computed tomography scan of the chest, abdomen, and pelvis for confirmation of diagnosis and metastasis, the patient underwent image-guided tissue biopsy, followed by neoadjuvant chemotherapy, left radical nephrectomy with separation of fused right ectopic renal moiety, and adjuvant chemoradiation.
    UNASSIGNED: This report shows an association of Wilms tumor with cross-fused renal ectopia, a rare combination. Unusual findings on imaging with unilateral flank mass should be considered as part of the differential diagnosis for this rare finding. Adjuvant chemotherapy and modern imaging helped delineate the anatomy and ease the surgery for safe resection, improving the overall outcome.
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  • 文章类型: Case Reports
    输尿管三联术是上尿路先天性畸形最少的一种。我们报告了一例37岁的男性患者,其右肾异位伴输尿管三联症,该患者是通过计算机断层扫描(CT)尿路造影诊断的。这是一个有趣的例子,因为,正如我们在回顾文献后发现的那样,演讲很有特色。
    Ureteral triplication is one of the least encountered congenital malformations of the upper urinary tract. We report a case of a 37-year-old male patient with right renal ectopia with triplication of the ureter which was diagnosed via computed tomography (CT) urography. This is an intriguing example because, as we discovered after reviewing the literature, the presentation is distinctive.
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  • 文章类型: Case Reports
    背景:交叉肾异位(CRE)是一种非常罕见的先天性肾脏异常。CRE通常是无症状的,通常是偶然发现的,但患者有时会出现各种肾脏表现。
    方法:我们报告了一个女孩的案例,该女孩有几次尿路感染的症状,其检查包括超声检查,Uroscan,肾脏扫描和排尿膀胱尿道造影显示,她有一个交叉的左肾异位,没有膀胱输尿管反流。定期随访显示没有进一步的症状或并发症,部分解决了肾积水,卫生规则后没有尿路感染的复发。这个病例不需要手术干预。
    CRE是一种罕见的先天性畸形。Uroscan是一个很好的工具来描述这种病理的全部解剖细节;和提供的信息是至关重要的外科医生,肾脏病学家,和放射科医生来帮助正确处理这种病理。
    结论:CRE是一种可以偶然诊断的罕见疾病。仅在出现并发症或存在其他相关肾脏疾病时才需要治疗。患者需要持续随访,并需要检查潜在的并发症。
    BACKGROUND: Crossed renal ectopy (CRE) is a very rare congenital kidney anomaly. CRE is usually asymptomatic and is most often discovered incidentally, but the patient may sometimes develop various renal manifestations.
    METHODS: We report a case of a girl who was symptomatic of several episodes of urinary tract infections and whose investigations including ultrasound, uroscan, renal scan and voiding cystourethrogram concluded that she had a crossed left renal ectopy without vesico-ureteral reflux. A regular Follow-up revealed no further symptoms or complications, with partial resolution of the hydronephrosis, and no recurrence of urinary tract infections after hygienic rules. This case didn\'t require surgical intervention.
    UNASSIGNED: CRE is an infrequently occurring congenital malformation. Uroscan is an excellent tool to describe the full anatomical details of this pathology; and the information provided is crucial for surgeons, nephrologists, and radiologists to aid in the proper handling of this pathology.
    CONCLUSIONS: CRE is a rare disease that can be diagnosed incidentally. Treatment is only indicated if complications occur or if there is other associated renal disease. Patients require continuous follow-up and need to be examined for potential complications.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    交叉和非融合的肾脏是极为罕见的先天性异常,其中一个或两个肾脏越过中线到另一侧。同时,输尿管插入膀胱的正常解剖位置。尽管交叉异位肾脏大多无症状,并且在其他疾病的检查过程中偶然发现,他们容易发生泌尿系统并发症,如尿路感染(UTI)。在这里,我们介绍了一名12岁的男性,有复发性尿路感染和尿retention留的病史,他因复发性尿路感染和尿retention留到急诊科就诊,最终发现右腰区域有异位未融合的左肾计算机断层扫描(CT)。
    Crossed and non-fused kidneys are an exceedingly rare congenital anomaly in which one or both kidneys cross the midline to the opposite side. At the same time, the ureters are inserted in their normal anatomical locations in the bladder. Although crossed ectopic kidneys are mostly asymptomatic and incidentally discovered during workup for other disorders, they are prone to urological complications such as urinary tract infections (UTIs). Here we present the case of a 12-year-old male with a history of recurrent UTIs and urinary retention who presented to the emergency department with recurrent UTIs and urinary retention and was eventually found to have an ectopic unfused left kidney in the right lumbar region on computed tomography (CT).
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