Successful retroperitoneal laparoscopic nephroureterectomy for thoracic kidney in a patient with ipsilateral ureteral cancer

A thoracic kidney is a scarce type of ectopic kidney. We report the case of a 76-year-old man who developed cancer of the ureter, ipsilateral to the thoracic kidney. He presented with abdominal pain in the right upper quadrant. Computed tomography revealed a right hydronephrotic kidney located in the thorax with elevation of the diaphragm. Further examination uncovered a cT2N0M0 ureteral cancer in the right upper ureter. A laparoscopic radical right nephroureterectomy was performed using a retroperitoneal approach. The retroperitoneal space was created for the usual port placement. A port between the 11th and 12th ribs was added to facilitate handling the suprahilar area, specifically the dissection of the superior aspect and separation of the kidney without accompanying pneumothorax. To our knowledge, this is the first report of a successful complete laparoscopic surgery via the retroperitoneal approach for a malignant disease associated with a thoracic kidney.