Renal hilar tumor with situs inversus- a case report and systematic review

Total situs inversus is a rare congenital condition (1 in 25,000) with mirror-image organ positioning, complicating nephrectomies. A 68-year-old female with situs inversus presented with a right renal hilum mass incidentally discovered. Imaging revealed a tumor difficult to distinguish from the renal artery and an elongated right renal vein mimicking left-sided anatomy. Radical nephrectomy achieved favorable recovery and preserved renal function. Reviewing 14 cases (1987-2024), focus has shifted to anatomical variations, especially vascular anomalies, affecting surgical complexity. Preoperative imaging to assess adjacent structures is crucial for optimizing surgical approaches and ensuring patient safety.