Open Access Peer-Reviewed
Case Report

Horseshoe kidney with cysts and a single ureter: a case report

Rim em ferradura com cistos e ureter único: relato de caso

Luis Alberto Batista Peres; José Roberto Leone; Ferreira; Sérgio Luiz Bader

Abstract:

Horseshoe kidney is the most common of all renal fusion anomalies, occurring in approximately 0.25% of the general population. Horseshoe kidney with only a single ureter is a rare anomaly. A 60-year- old man was admitted to hospital for routine health screening. His family history was negative for kidney diseases, and there was no abnormality in his physical examination. A computed tomography (CT) scan revealed an atypical horseshoe kidney with cysts and three-dimensional spiral CT reconstruction showed the presence of a single ureter. The patient has since been followed up for two years without any signs of clinical disease. We report a rare case of a patient with a horseshoe kidney with cysts and a single ureter that was diagnosed incidentally.

Descriptors: genito urinary abnormalities, polycystic kidney diseases, cysts.

Resumo:

O rim em ferradura é a mais comum de todas as anomalias de fusão, ocorrendo em aproximadamente 0,25% da população geral. O rim em ferradura com ureter único é uma rara anomalia. Um paciente do sexo masculino de 60 anos foi admitido para investigação rotineira de triagem. Sua história familiar era negativa para doenças renais e o exame físico foi considerado normal. A tomografia computadorizada revelou um rim em ferradura atípico com cistos e a reconstrução tridimensional na tomografia computadorizada mostrou a presença de um único ureter. O paciente encontra-se assintomático após dois anos de seguimento. Apresentamos um raro caso de paciente portador de rim em ferradura com cistos e ureter único diagnosticado incidentalmente.

Descritores: anormalidades geniturnárias, cistos, doenças renais policísticas.

INTRODUCTION

Horseshoe kidney is the most common of all renal fusion anomalies, occurring in approximately 0.25% of the general population. It is usually asymptomatic, but can be associated with nephrolithiasis, ureteropelvic junction stenosis, renovascular hypertension, polycystic kidney and polycystic liver.1

Horseshoe kidney with only a single ureter is a rare anomaly. Associated extra-urinary anomalies have been described such as situs inversus totalis, and congenital scoliosis. There is a single report of neoplasia in a horseshoe kidney that had pyelic fusion and a single ureter.2 This case report describes the incidental diagnosis of a horseshoe kidney with a single ureter.


CASE REPORT

A 60-year-old man was admitted to hospital for routine health screening. His family history was negative for kidney diseases, and there was no abnormality in his physical examination. Abdominal ultrasonography revealed a horseshoe kidney with multiple cysts. A computed tomography (CT) scan revealed an atypical horseshoe kidney with cysts (Figure 1) and three-dimensional spiral CT reconstruction showed the presence of a single ureter (Figure 2). The patient has since been followed up for two years without any signs of clinical disease.


Figure 1. Computed tomography (CT) scan revealed an atypical horseshoe kidney (large arrow) with cysts (thin arrow).


Figure 2. Three-dimensional spiral CT reconstruction showed the presence of a single ureter.



DISCUSSION

Horseshoe kidney is the commonest of all renal fusion anomalies. It is usually asymptomatic, but the affected individuals are prone to a variety of complications, such as stone disease, pelviureteric junction obstruction, trauma, infections and tumors. As a result of the abnormal anatomy, imaging and treatment vary substantially from that of the normal kidney.3

Horseshoe kidney with a single ureter is a rare anomaly. The aetiology of the malformation is unknown. Associated extra- -urinary anomalies have been described, such as pyelic fusion and crossed single ureter.1

We report a rare case of a patient with a horseshoe kidney with a single ureter that was diagnosed incidentally and in which the patient has remained asymptomatic after two years of follow-up.


REFERENCES

1. Peres LAB, Ferreira JRL, Delfino VDA. Polycystic horseshoe kidney. Nephrol Dial Transplant 2007; 22:652-3.

2. Costa RP, Schaal CH, Navarro FC. Neoplasia in horseshoe kidney with pyelic fusion and crossed single ureter. Int Braz J Urol 2004; 30:319-20.

3. Yesilli C, Erdem O, Akduman B, Erdem Z, Gundogdu S, Mungan NA. Horseshoe kidney with pyelic fusion and crossed single ureter. J Urol 2003; 170:175-6










1. Department of Nephrology, Cascavel State University, Brazil
2. Department of Radiology, Cascavel State University, Brazil
3. Department of Urology, Cascavel State University, Brazil

Corresponding author:
Dr. Luis Alberto Batista Peres
R São Paulo, 769/901, Cascavel
Paraná - Brazil CEP: 85801-020
Phone/Fax: 55 (45) 3327- 3413
Email: peres@certto.com.br

Submitted on: 08/14/2009
Approved on: 12/16/2009

We declare no conflict of interest


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