Bacl^round of studyPolythelia is a cutaneous marker of congenital diseases of the kidneys. Lateral displacement of the nippies (e.g. laterally located to their respective midciavicular lines) is eonsidered a further sign of renal disorders, particularly of bilateral renal hypoplasia. as reported by Fleisher in a detailed study on seven infants.Subject We observed a 45-year-oId white man with his morphologically normal nipples displaced on the lateral aspeets of the trunk without any other consistent clitiical features such as aeeessory nipples or areolae, gonadal dysgenesis, face or ear anomalies.Aims and metbods In order to reveal congenital abnormalities of the kidneys and the urinary collecting systems the following investigations were undertaken: renal ultrasound, intravenous pyclography, abdomen CT and NMR scans, urethrocystography, transurethral eystoseopy, urinalysis, laboratory tests including karyotype, ECG and cardiovascular evaluation.Results Instrumental findings disclosed a hypoplastie left kidney in an ectopic site, loeated below the right kidney (cross type of renal ectopy) without any connection between their urinary eoilecting systems. Complex malformations of the urinary traet such as an orthotopic narrow right ureteral orifice and ridge, a large-sized divertieulum on the left wall of the bladder were also present. Moreover, a tumour on the upper pole of the right kidney, 20 mm in diameter, with a histologieal picture of renal-cell carcinoma was detected.Conclusions A lateral displacement of the nipples is a clue for the presence of renal hypoplasia both bilateral and unilateral. The significance of this association is unclear and its occurrence is probably underestimated. Prcsenled as an oral communicalion al the Ilird Congress of the European Academy of Dermatology and Venereology, " Corresponding auihor. Tci: ( + 34 2) 58187551. Fax; ( + 39 26-.30/9/1993. Copenhagen. Denmark. 2) 8321645; ( + 39 2) 58187.500. ()926-9959/95/$09.30 e 1995 Elsevier Science B.V. All rights reserved SSDI 0926-9959(94)00053-3