LAUSR

To the Editor: A 42-year-old woman was admitted to our hospital with the complaints of intermittent groin and low back pain for 6 months. The patient had been under losartan treatment due to hypertension for 2 years. On admission, she was fully oriented and hemodynamically stable. Physical examination revealed a heterogenous mass that was palpable over the left lower abdomen and suprapubic region. The left groin was painful with palpation as well. Laboratory test results showed that the hemoglobin level was 12.5 g/dL, blood urea nitrogen was 24 mg/dL, and creatinine level was 0.9 mg/dL; urine analysis revealed 2 positive red blood cells, negative white blood cells, and no casts. Urine culture test results were negative. Clotting tests were all within the normal range. Abdominal ultrasound showed that the patient had polycystic kidneys without kidney stones and ectasia; however, the left kidney was located in the pelvis. Magnetic resonance imaging revealed multiple renal cysts in the right kidney, absence of the left kidney, and an ectopic kidney with multiple cysts in the true pelvis (Figure 1). Autosomal-dominant polycystic kidney disease (ADPKD) may present with acute or chronic pain. Chronic pain is generally due to enlarged cystic kidneys causing stretching of the capsule or traction of the renal pedicle. Mechanical pain also occurs due to enlarged cysts that resulted in lumbar lordosis and back pain. Paraspinal muscle group hypertrophy has been observed in ADPKD patients with back pain. In fact, groin pain is not a usual complaint in patients with ADPKD in the absence of kidney stones or urinary tract infection. In this case, we presented a patient with groin pain with ADPKD and pelvic left kidney localization to diagnose the disease. There were only 2 cases in the literature with pelvic polycystic kidney disease. In conclusion, we suggest that groin pain—with or without urinary tract infection or kidney stones—should alert the clinician to the possible presence of an ectopic organ in the pelvic area.