Delayed diagnosis of pancake kidney (completely fused pelvic renal ectopia) in a 49-year-old woman presenting with lower urinary tract symptoms in a low-resource setting: A case report

Complete fused renal ectopia, also known as pancake kidney, is a rare congenital renal fusion anomaly characterized by complete fusion of both kidneys within the pelvis. Most patients remain asymptomatic and diagnosis is often incidental. I report a 49-year-old woman from a low-resource setting who presented with lower urinary tract symptoms and dyspareunia. Initial management was directed toward recurrent cystitis; however, further evaluation with computed tomography and intravenous urography revealed a pancake kidney located in the pelvis with two distinct collecting systems and normally draining ureters. No evidence of obstructive uropathy, renal mass lesion, or associated complications was identified. This case highlights the diagnostic challenge posed by nonspecific clinical presentation and limited access to advanced imaging in low-resource settings, which may contribute to delayed or incidental diagnosis of congenital renal anomalies.