Renal Cell Carcinoma of Pelvic Kidney with Atypical Nodal Metastasis: A Diagnostic Challenge

Ectopic pelvic kidney is a known congenital anomaly; however, the presence of renal cell carcinoma (RCC) in an ectopic kidney is rare with the evidence available in the form of a few case reports only. In this case report, we present a case of metastatic RCC in the pelvic kidney which became a diagnostic challenge because of atypical contrast-enhanced computed tomographic (CT) characteristics and unusual pattern of lymph node involvement including cervical lymph node in the absence of visceral metastasis. Because of its unusual location and uncertain vascular anatomy, ectopic kidney poses a surgical challenge. Owing to the rarity of this condition, optimal surgical approach, metastatic potential, routes of metastasis, and effectiveness of systemic agents in pelvic RCC compared to RCC in a normally located kidney, are largely unknown.