Renal Cell Carcinoma at Lower Pole Moiety of Adult Left Duplex Kidney

Duplex kidney (DK) is the most common congenital abnormality of the urinary tract, with an incidence of around 0.82%1,2. Basis of duplex kidney formation by embryology is explained as development of two ureteral buds separately from a single mesonephric duct gives rise to a duplex kidney with complete ureteral duplication. On the other hand, bifurcation of a single ureteral bud proximal to the ampulla gives rise to a duplex kidney with a bifid pelvis or ureter3. Duplex system is explained as the kidney with two pyelocaliceal systems, which may have either single or bifid ureter (partial duplication) or double ureterdraining separately into the urinary bladder (complete duplication), with a single renal parenchyma that is drained by two pyelocaliceal systems4. In literature review it is well documented that duplex system is associated with complications such as hydronephrosis, calculi formation, ureterocele, vesicoureteric reflux and recurrent infection5. Duplex system is also prone to development of renal pelvis carcinomas as compared to normal kidney because of continuous injury from repeated infection, trauma and inflammation from calculi resulting into urothellial metaplasia and neoplasia6,7.