Crossed Fused Renal Ectopia: Varied Presentation, Diagnostic Challenges and Management

Aim: Crossed fused renal ectopia (CFRE) is a rare congenital anomaly, majority being asymptomatic but varied presentations have been reported. This study was conducted to evaluate the clinical profile and the challenges posed in the management of this entity. Materials and Methods: This was a descriptive study analysing the varied presentation, challenges in the diagnosis and management of ten patients diagnosed with crossed renal ectopia with fusion during the period from January 2019 to June 2021. Patients were diagnosed as a case of CFRE during investigations for abdominal pain, abdominal mass, genitourinary malformation and urinary tract infection. Results: The left moiety was crossed and fused with the right moiety in 5 cases and opposite in rest. Ultrasonography was found to be a good screening investigation with useful diagnostic contributions from CT scan, radionuclide scintigraphy and magnetic resonance urography. Out of ten, total six patients required intervention, rest were managed conservatively. In three patients, there was hydronephrosis secondary to ureteropelvic junction obstruction and underwent pyeloplasty. In one of the patients there was bilateral undescended testis and underwent bilateral orchidopexy. Two patients had calculus in ectopic kidney for which one had undergone lap pyelolithotomy and other patient underwent percutaneous nephrolithotomy (PCNL). All patients were asymptomatic at last follow-up with stable renal functions. Conclusions: Crossed fused renal ectopia was detected in most patients as an incidental finding. Associated urological problems were found and appropriate surgical management were done, in minimal invasive way.