Renal hilar tumor with situs inversus- a case report and systematic review

Total situs inversus is a rare congenital condition (1 in 25,000) with mirror-image organ positioning, complicating nephrectomies. A 68-year-old female with situs inversus presented with a right renal hilum mass incidentally discovered. Imaging revealed a tumor difficult to distinguish from the renal artery and an elongated right renal vein mimicking left-sided anatomy. Radical nephrectomy achieved favorable recovery and preserved renal function. Reviewing 14 cases (1987–2024), focus has shifted to anatomical variations, especially vascular anomalies, affecting surgical complexity. Preoperative imaging to assess adjacent structures is crucial for optimizing surgical approaches and ensuring patient safety.