Pancake kidney; An unusual type of renal fusion anomaly found in DMSA renal scintigraphy

Introduction: Renal fusion anomalies described as congenital fusion of the kidneys either partially or completely occurred in the early embryonic period.Case report: A 2.5 -year-old boy with a history of the previous incidental finding of an ectopic kidney on abdominopelvic ultrasonography was referred to our nuclear medicine center for 99m Tc-DMSA renal scintigraphy. He was asymptomatic and his urine analysis and renal function tests were in the normal range. Abdominopelvic ultrasonography demonstrated fused ectopic kidneys which were located on the right side of the lower abdomen with separated pyelocaliceal (PC) systems. Three hours after intravenous injection of 1mCi (37MBq) 99m Tc-DMSA scanning was performed in multiple static views, using a dual-head variable angle gamma camera with a low-energy high-resolution parallel-hole collimator. The scan showed an unusual type of ectopic fused kidneys on the right side of the lower abdomen. Discussion: Pancake kidney represent complete type of renal fusion anomaly. In this anomaly kidneys were fused completely across a medial portion of both upper and lower poles, as well as hilum, without any septum. Also, each kidney consists of own collecting system. Early detection of possible associated complications including urinary tract infection and urinary obstruction is recommended. Scintigraphic methods provide static and dynamic images to precisely assess renal volume, function and possible contributed defects due to the probable urinary tract infection or vesicoureteral reflux.Conclusion: 99m Tc-DMSA scanning is a valuable imaging method for detection of renal shape anomalies

کلیدواژه ها:

Pancake kidney ، renal fusion anomaly ، DMSA renal scintigraphy