875 Ectopic left renal artery originating from left common iliac: a rare anatomic variation

Abstract

<h3>Introduction/Background*</h3> Main objective is to present the case of a rare anatomic variation observed during laparotomy procedure along with performing a relative review of the literature. <h3>Methodology</h3> Medical eleents of patient were reviewed with special focus on epidemiological, surgical and histopathological characteristics. A comprehensive review of published literature in Pubmed, with special focus on meta-analyses and prospective studies, was also performed. <h3>Result(s)*</h3> A 56-year old woman was operated with laparotomy to peform full surgical staging with total hysterectomy with bilateral salpingoophorectomy, pelvic lymphadenectomy, paraaortic lymphadenectomy and infracolic omentectomy because of initial diagnosis of serous endometrial cancer. During laparotomy procedure, the diagnosis of an ectopic left renal artery (LRA) originating directly from the left common iliac artery (LCIA) was made. Woman was already known to have an ectopic pelvic kidney (EPK). EPK was found in retroperitoneal space, approximately in the level of sigmoidal bend. The LRA indeed originated just 2 cm below the level of bifurcation, while the left renal vein (LRV) was originated relatively from the left iliac vein (LIV) also 2-3 cm below the level of venal bifurcation, having a parallel route just below the LRA. To our knowledge, this is the first published case of such an anatomical intraoperative finding, which indicates the high complexity degree that may characterize the performance of a para-aortic lymphadenectomy. <h3>Conclusion*</h3> Appropriate preoperative imaging evaluation of potential anatomic variations based on imaging findings may contribute in avoiding significant intraoperative challenges.