Oncocytic carcinoid tumour of the bladder.

CORRESPONDENCE If you have a burning desire to respond to a paper published in the Journal of Clinical Pathology, why not make use of our ''rapid response'' option? Log on to our website (www.jclinpath. com), find the paper that interests you, and send your response via email by clicking on the ''eLetters'' option in the box at the top right hand corner. Providing it isn't libellous or obscene, it will be posted within seven days. You can retrieve it by clicking on ''read eLetters'' on our homepage. The editors will decide as before whether to also publish it in a future paper issue. Ectopic supernumerary kidney presenting as inguinal hernia Supernumerary kidney is one of the least common forms of congenital renal abnormality and is usually discovered when it presents complications. 1 2 The diagnosis of supernumerary kidney is confined to a mass of renal tissue that has no parenchymatous connection with the definitive kidney. 3 The published literature on supernumerary kidney is scarce. Here, we report a case that presented as indirect inguinal hernia. A 36 year old man suffering from chronic asthma presented with a painful swelling in the left inguinal region, which he first noticed one month previously. The swelling measured 5.0 6 4.0 cm, was situated on the medial aspect of the inguinal ligament, and was reducible with positive cough impulse. The scrotum on the left side was empty. An abdominal scan showed normal organs, including two normal kidneys. A diagnosis of indirect inguinal hernia with undescended left testis was made and the patient underwent surgery. The hernial sac included an atrophic testis (2.0 6 1.5 6 1.0 cm) and another small bean shaped mass (3.0 6 2.0 6 2.0 cm), which was studied histopathologically. The testis showed a positive string sign on the cut surface. The other mass had a grey white cut surface, with an intact capsule. Sections of the testis showed seminiferous tubules with thickened basement membranes containing inactive germ cells and some having only Sertoli cells. These features were consistent with cryptorchid testis. Sections from the bean shaped mass showed a kidney-type structure, with cortex and medulla. The glomeruli and tubules were seen in their developmental stages, with immature mesenchymal tissue interspersed in between (fig 1). These features were consistent with a diagnosis of supernumerary kidney because the patient had two normal kidneys in the abdomen. A supernumerary kidney is a rare …