Cytoreductive surgery for ovarian cancer with pelvic ectopic kidney: a case report

Pelvic ectopic kidney is a rare congenital anomaly, occurring in approximately 0.1% of the adult population, and is often asymptomatic. However, it can easily be mistaken for a pelvic tumor or lymph-node metastasis. This case report details a rare presentation of cytoreductive surgery for ovarian cancer with a pelvic ectopic kidney. A 56-year-old Chinese woman was incidentally found to have a pelvic mass accompanied by a pelvic ectopic kidney during evaluation for hip pain. Pathology following cervical lymph-node biopsy was consistent with high-grade serous adenocarcinoma. Comprehensive assessment via supraclavicular lymph-node biopsy, PET-CT, and multidisciplinary team (MDT) discussion confirmed ovarian cancer stage IVb with coexisting pelvic ectopic kidney. Treatment consisted of neoadjuvant chemotherapy with paclitaxel plus carboplatin followed by interval cytoreductive surgery achieving complete resection of all pelvic and abdominal lesions. Postoperative pathology verified high-grade serous ovarian carcinoma, stage IVb. Serum creatinine on postoperative day 1 was 78 µmol/L and remained stable; the patient was discharged on day 12. Post-discharge renal scintigraphy showed no decline in total GFR, and no renal or surgical complications occurred. This case underscores the importance of MDT management and thorough diagnostic work-up when performing cytoreductive surgery for ovarian cancer in the setting of pelvic ectopic kidney. Increased clinical awareness of this scenario helps avoid misdiagnosis, optimizes patient outcomes, and provides a reproducible technical roadmap for similar complex cases.