Rare case of thoracic kidney detected by renal scintigraphy

Abstract

Intrathoracic kidney is a rare congenital abnormality with lowest frequency among all renal ectopias. Patients with thoracic kidneys are usually asymptomatic, and the condition is usually discovered incidentally during radiological evaluation for other conditions or during thoracic surgery. We report a case of a 62-year-old male who was referred to our department for renal scintigraphy for a nonvisualized left kidney on ultrasonography report. Both Tc-99m dimercaptosuccinic acid and diethylenetriaminepentaacetic acid scans revealed a left thoracic kidney which was confirmed by CT scan of the thorax and abdomen.

Right Diaphragmatic Eventration with an Intrathoracic Kidney: Case Report and Review of the Literature

“…This finding is usually incidental, and the first case diagnosed was reported in 1940 by Wolfromm in a woman aged 42 years. Since then, about 200 cases have been reported [7]. This occurrence is described as frequent in the male sex (63%) and on the left side (62%) [8, 16, 29].…”

“…According to the most accepted theory, the kidney reaches the adult location at the eighth gestational week followed by the superior accelerated migration of the metanephros and the delay in mesonephros involution before completing the diaphragmatic development, that is, before the fusion of the pleuroperitoneal membrane. The persistence of the nephrogenic cord or effects of the liver and adrenal gland development are also described in the pathogenesis [7–9, 16, 29–33]. None of these mechanisms can explain the alteration by itself.…”

“…Thoracic renal ectopia is rare, with a prevalence of 1 in 10,000 cases of ectopic kidneys. There are about 200 published cases, mainly in male adults with the involvement of the left kidney [7, 8]. These are discovered incidentally with imaging studies.…”

Bochdalek hernias associated with intrathoracic kidney: A case report and systematic review of outcomes including renal function

“…Abdominal ultrasound reports often describe an atrophic or missing kidney, so in such cases, follow-up chest imaging to avoid misdiagnosis is advised. Renal scintigraphy with DMSA provides an estimate of split renal function and can exclude reflux and obstruction [20].…”

“…As discussed, 1 case reached ESKD in the context of renovascular hypertension secondary to stenosis of the artery supplying the intrathoracic kidney. Of the 2 cases with reported CKD, 1 had hydronephrosis of the thoracic kidney and a multicystic contralateral kidney [25], and the other case may have been attributable to underlying diabetes and hypertension [20].…”