Horseshoe kidney (HSK) is the most common renal
fusion anomaly, it occurs in 0.25% of the individuals[1].
Patients are often asymptomatic and the anomaly
is often incidentally discovered. However, when
symptomatic, it is related to hydro-nephrosis, infection,
or calculus formation [2]. HSK is associated with an
increased risk of renal malignancy, with a relative risk
of 1.76 to 7.93 times higher than that observed in the
general population[3]. Renal call carcinoma (RCC) is
the most common neoplasm associated with HSK [2].
HSK is often associated with multiple renal arteries
and veins [4], therefore resection of RCC in HSK is
associated with challenges. Computed tomography
(CT) utilizing routine renal mass protocol and CT
angiography is the primary imaging modality of choice
for localization and staging of any renal tumour and
essential to study the renal vasculature.