Ectopic Dysplastic Kidney
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A 52-year-old man with a history of sarcoidosis presented with continuous right flank and back pain for four months. Contrast-enhanced CT abdomen and pelvis revealed a lobulated soft tissue lesion extending from the aortic bifurcation to the anterior margin of L5 that measured up to 8 cm in craniocaudal dimension and contained peripheral ring-like foci of calcification. The right kidney was not visualized. Review of a CT performed four years prior demonstrated the stability of this lesion. The presumed diagnosis of the ectopic kidney was confirmed with a cystoscopy with retrograde pyelography. The patient has counseled that the presence of the ectopic kidney was unlikely to be the cause of his pain. However, due to significant pain and patient anxiety, which was due in part to the delay in diagnosis, the ectopic kidney was surgically removed at the patient’s request. Postoperatively, the patient reported the right flank and back pain was improved for a “short period” but more recently he reported that it was coming back. He is being managed with pain medications, including Tylenol.

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