Laparoscopic nephrolithotomy in a patient with crossed fused renal ectopia

Background. A 32-year-old man was referred to a tertiary care center for stone management. The patient had initially presented to his primary physician 3 months earlier with right flank pain of 2 month's duration. Abdominopelvic ultrasonography and intravenous urography had revealed left-to-right crossed fused renal ectopia with a 25 mm opaque stone in the crossed kidney. The patient had received two sessions of extracorporeal shock wave lithotripsy, which had failed to remove the renal stone.Investigations. Noncontrast CT, blood tests (hemoglobin and creatinine levels), abdominopelvic ultrasonography and intravenous urography.Diagnosis. Left-to-right crossed fused ectopia with a 25 mm opaque renal stone in the anomalous kidney.Management. The patient underwent laparoscopic nephrolithotomy to remove the renal stone. Intravenous urography and abdominopelvic ultrasonography 1 month after surgery confirmed that the patient was stone free and had functional renal units. The patient will be followed up every 3 months with abdominopelvic ultrasonography for early detection of stone recurrence.