RENAL CELL CARCINOMA AT LOWER POLE MOIETY OF ADULT LEFT DUPLEX KIDNEY

Abstract

Duplex kidney is an entity which is one of commonest congenital urinary
tract anomalies. Overall incidence is 0.8-2 % with bilateral in 20% of cases
along with female preponderance. Presentation of duplex kidney and diag-nosis is common at pediatric age and rarely presents at adulthood because
of complications associated with duplex kidney. Duplex system is defined as
kidney with two pelvicalyceal system with single or double ureter or single
renal parenchyma containing two pelvicalycealsystems. In literature review it
is well documented that duplex system is associated with complications such
as hydronephrosis, calculi formation, ureterocele,vesicoureteric reflux and re-current infection. Duplex system is also prone to development of renal pelvis
carcinomas as compared to normal kidney as was in our case.in literature only
four cases of renal cell carcinoma have reported so far which were associated
with duplex kidney but these were either multicystic transitional cell carci-nomas of renal pelvis or one case of cystic renal cell sarcomatoid carcinoma.
Here we present very rare case of duplex kidney with lower pole moiety renal
cell adenocarcinoma of solid nature. Patient presented with left lion pain and
burning micturition. Patient had history of recurrent infection with left lumber
pain in the past. Ultrasound, intravenous pyelogram and CT SCAN of abdo-men revealed duplex kidney and double ureters on left side with large solid
enhancing mass in lower pole moiety left kidney. Histopathology confirms
diagnosis of renal cell adenocarcinoma. It is vital to detect duplex system at
earliest stage to detect associated complications especially renal carcinoma
using imaging so as to conserve partial kidney and its function while remove
tumor at early stage in order to reduce morbidity and mortality .