title: Four miniature kidneys: supernumerary kidney and multiple organ system anomalies.
abstract: More than 350 years after Martius's first reported case in 1656, supernumerary kidney (SNK) continues to fascinate the world of medicine, generating new ideas in the domain of embryogenesis. Association of a normal kidney with a second or third ipsilateral smaller kidney is an extremely rare anomaly with only a total of 81 cases reported until today. We are reporting a case of SNK, clinically diagnosed as right hydronephrosis, associated with an ipsilateral ectopic ureter, a contralateral partially duplicated ureter, and a multiseptate gallbladder. Pathologic examination of the nephrectomy revealed 4 miniature kidneys, joining a dilated ureter through 4 separate conduits. Our patient is the first reported case of SNK with absent ipsilateral normal kidney, presence of more than 3 kidneys on 1 side, and associated anomaly in the gallbladder. This case represents a unique combination of rarities, suggesting insights in the domain of molecular embryology.
authors.affiliation: Department of Pathology, Division of Surgical Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA. Electronic address: maafrouz@utmb.edu.
authors.forename: Marjan
authors.initials: M
authors.lastname: Afrouzian
authors.affiliation: Department of Surgery, Division of Urology, University of Texas Medical Branch, Galveston, TX 77555, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Sonstein
authors.affiliation: Department of Pathology, Division of Surgical Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Dadfarnia
authors.affiliation: Department of Surgery, Division of Urology, University of Texas Medical Branch, Galveston, TX 77555, USA.
authors.forename: J Nicholas
authors.initials: JN
authors.lastname: Sreshta
authors.affiliation: Department of Pathology, Division of Surgical Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA.
authors.forename: Hal K
authors.initials: HK
authors.lastname: Hawkins
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis; D000328:Adult; D005704:Gallbladder / Q000002:abnormalities; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis; D007668:Kidney / Q000002:abnormalities* / Q000196:embryology / Q000601:surgery; D008297:Male; D009392:Nephrectomy; D014513:Ureter / Q000002:abnormalities; D014564:Urogenital Abnormalities / Q000175:diagnosis
keywords: Anomaly; Gallbladder; Kidney; Supernumerary