Right Iliac Ectopic Kidney With an Extrarenal Pelvis, Aberrant Upper-Pole Arterial Supply, and Multiple Renal Cysts

Renal ectopia results from an abnormal arrest of renal ascent during embryonic development and is often associated with malrotation, unusual vasculature, and anomalies of the collecting system. Although numerous ectopic kidneys are asymptomatic and discovered incidentally, their variant anatomy holds clinical significance as it may interfere with imaging interpretation and surgical procedures. We present a case of a right iliac ectopic kidney identified during the routine dissection of an 82-year-old male donor. The kidney was located in the right iliac fossa and demonstrated marked anterior malrotation, a large extrarenal pelvis, a solitary aberrant artery originating from the right common iliac bifurcation and entering the superior pole, venous drainage into the right common iliac vein, and multiple cortical and medullary cysts. The contralateral kidney was situated in its normal position and was grossly unremarkable. This combination of positional, vascular, collecting-system, and parenchymal variations exemplifies the complexity of renal ectopia and underscores the importance of meticulous anatomical identification. Understanding these variants is essential for radiologists, surgeons, and anatomists, as failure to recognize an ectopic kidney may result in diagnostic errors or iatrogenic injury during pelvic and vascular interventions.