OVARIAN MASS MIMICKING ECTOPIC PELVIC KIDNEY TUMOR: A CASE REPORT AND SIGNIFICANCE OF LAPAROSCOPY

Introduction: Pelvic kidney is seen in between 1: 900 - 1: 1200 of the population and development of renal cell carcinoma is very rare in pelvic kidneys. Materials and Methods: A 68 year old lady with a known right pelvic kidney was admitted to our urology outpatient clinics with right lower quadrant abdominal pain. A suspicious mass on the upper pole of the pelvic kidney was detected on radiologic evaluation. Patient's history, diagnostic work-up and treatment are presented and discussed. Results: Physical examination revealed right abdominal lower quadrant tenderness. Abdominal ultrasound (USG) showed a 3.5x4 cm sized hypoechogenic mass located on the right side of the urinary bladder in the pelvis with reduced blood flow on Doppler USG. Abdominal computed tomography demonstrated a 3.5x4 cm sized mass located on the upper pole of the pelvic kidney which was also on the right side of the urinary bladder. Mercaptoacetyltriglycine (MAG-3) scinthigraphy showed similar functions of both kidneys without any obstruction. Transperitoneal laparoscopy revealed a pediculated 3.5x4 cm sized mass lesion of the rigth ovary which was excised with its pedicle. No tumor was observed in the pelvic kidney during laparoscopy. Histopathologic diagnosis of the ovarian mass was reported as fibroma. Conclusion: Tumors of the ovaries might be misdiagnosed radiologically as pelvic kidney tumors due to their close anatomical relationship in patients with pelvic kidneys. We recommend transperitoneal laparoscopic approach in this patient group rather than open laparatomy as minimally invasive diagnostic and therapeutic surgical modality.