Pancake kidney: when it is not a problem

Pancake kidney is a very rare congenital anomaly involving complete fusion of medial renal parenchyma. The interface is devoid of any intervening septum. As described, the kidneys form a single lobulated mass in pelvic location. However, dual collecting systems are retained, and the shortened, anteriorly seated ureters enter the bladder normally. This condition is usually discovered incidentally but may confer a heightened susceptibility to recurrent urinary tract infections or stone formation, given the likelihood of anomalous collecting system rotation and the potential for ureteral stasis or obstruction. Excretory urography, the customary method of detection, has been replaced by ultrasonography, CT, MRI, and radionucleotide scanning. Herein, we present a male patient with a pelvic pancake kidney, never symptomatic. A conservative approach of regular follow up visits and laboratory testing was elected, thus avoiding any unnecessary investigations or extensive surgery.