Open pyelolithotomy in incompletely duplicated kidney with contralateral crossed fused ectopia: A rare case report

Crossed fused renal ectopia is a rare congenital anomaly that can lead to urinary stasis, infection, and stone formation, although its aberrant anatomy often complicates both endoscopic and percutaneous access and treatment. We report a 68-year-old man presenting with recurrent right flank pain. Imaging revealed left-to-right crossed fused ectopia with a mal-rotated left kidney fused to an incompletely duplicated right kidney. A large stone was detected. The patient underwent an open pyelolithotomy, achieving near-complete clearance. This case highlights the continued role of open surgery in managing large stones in anomalous kidneys when minimally invasive options are unsafe or infeasible.