Ectopic Kidney with an Ectopic Ureter Masquerading Adnexal Mass: A Case Report and Literature Review

Figures & data

Figure 1 Images of computerized tomography urography (CTU). There were no abnormalities in the shape and position of the right kidney, and no dilation of the right ureter. No normal kidney was found in the left renal area (A). An ectopically dysplasia kidney with peripheral enhancement could be seen anterior to fifth lumbar vertebra (B). Spotted contrast media was demonstrated around the ectopic kidney (thick arrow, (B). However, an enlarged uterus can be seen (C) and the thick-walled dysplasia kidney resembles an ovarian cyst (thick arrow, (D).

Figure 2 Images of MR. Sagittal turbo spin-echo (TSE) T2-weighted imaging (T2WI) (A-C), coronal T2WI (D-E), and axial T2WI with fat suppression (F). Sagittal and coronal T2WI showed an oval cyst in the right ovary (A and D). Another oval-shaped cystic lesion is observed above the uterus, with a long tubular tortuous downward extension on the left side of the pelvic cavity (B and E). However, careful examination revealed a maldeveloped ureter accompanying the uterus, the end of which was fused with the vagina (C and F). (Arrow: ectopic kidney; dotted line box: ectopic ureter).

Figure 3 Intraoperative endoscopic data. (A) (a) Laparoscope showed septate uterus. A retroperitoneal cyst was dissociated from left ovary and fallopian tube. (b) The mass, probably be an ectopic kidney (arrow), was separated from surrounding tissue, and the distal end extended to nearby bladder. (B) Cystography imaging showed right ureter opening (dotted box) in bladder (a), but detected no left ureter opening (b).

Figure 4 Gross of dysplasia ectopic kidney. Photograph shows the excised kidney with single system ureter.

Table 1 Summary of Previous Publication of Ectopic Pelvic Kidney Mimicking Other Diseases

Reference	Age	Sex	Misdiagnosed Diseases	Associated renal Complications	How was Ectopic Kidney Confirmed
Jose R et al (2000)^Citation12	64	Female	Gastrointestinal bleeding	None	Ultrasound
Malhotra et al (2001)^Citation13	24	Female	Ovarian cyst	Hydronephrosis	Surgical exploration
Reddy et al (2003)^Citation14	Unknown	Unknown	Chilaiditi syndrome	Calculi	CT and MRI
Pryma et al (2005)^Citation15	57	Female	Tumor metastasis	Hydronephrosis	CT
Blackmon et al (2011)^Citation16	9	Female	Meckel’s diverticulum	None	Surgical exploration
Yadav et al (2013)^Citation17	45	Male	Retroperitoneal dermoid cyst	Mucinous cystadenocarcinoma	Ultrasound
Taylor et al (2019)^Citation18	21	Female	Acute appendicitis	Renal calculi	Ultrasound and CT
Xu et al (2019)^Citation19	60	Female	Acute appendicitis	Pyelonephritis	CT
Manglik et al (2022)^Citation20	42	Male	Acute appendicitis	Pyelonephritis	CT

Table 2 Reports of Ectopic Kidney Combined with Ectopic Vaginal Ureter Causing Female Urinary Incontinence

Reference	Age	Type of Ectopic Kidney and Ureter	Associated Genital Anomalies	Management
Gharagozloo et al (1995)^Citation22	3.5	Dysplastic kidney, single ureter	/	Nephroureterectomy
	5	Dysplastic kidney, single ureter	Septated vagina	/(severe congenital heart disease)
	9.5	Dysmorphic kidney, single ureter	/	Nephroureterectomy
	13	Dysplastic kidney, single ureter	/	Nephroureterectomy
	16	Dysplastic kidney, single ureter	/	Nephroureterectomy
Moores et al (1998)^Citation23	12	Small kidney, single ureter	/	Nephroureterectomy
Sameshima et al (2005)^Citation24	65	Agenesis kidney, single ureter	Bicornuate uterus with a rudimentary left horn	Radical hysterectomy and vulvo-vaginectomy with systemic lymph nodes resection (vaginal adenocarcinoma)
	38	Agenesis kidney, single ureter	Bicornuate uterus with a rudimentary left horn	Radical hysterectomy with pelvic lymph nodes resection (cervical cancer)
Kraft et al (2007)^Citation25	10	Fused-crossed, dysplastic kidney, single ureter	/	Extravesical ureteral reimplantation
Kumar et al (2007)^Citation26	22	Hypoplastic kidney, single dilated ureter	Congenital vesicovaginal fistula, transverse vaginal septum	Nephroureterectomy
Iwatsuki et al (2009)^Citation27	3	Hypoplastic kidney, single ureter	/	Nephroureterectomy
Lin et al (2010)^Citation28	4.5	Fused-crossed, dysplastic kidney, single ureter	/	Nephroureterectomy
Chen et al (2013)^Citation21	20	Hypoplastic kidney, Y-type partial duplicated ureter	Bicornuate uterus	Nephroureterectomy
Zhang et al (2018)^Citation29	30	Dysplastic kidney, single ureter	Herlyn–Werner–Wunderlich syndrome	Nephroureterectomy
Amenu et al (2021)^Citation8	22	Atrophied kidney, single ureter	/	Surgical reimplantation through vaginal
Hussen et al (2023)^Citation7	24	Dysplastic kidney, single ureter	/	Nephroureterectomy

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Data Sharing Statement

Data used in the study are available from the corresponding author on request.