A 36-year-old gentleman presented with history of fever. The respiratory system examination was unremarkable. Chest radiograph revealed elevation of the right hemi-diaphragm. A smooth round mass was seen extending into the chest near the midline on a posteroanterior radiograph (Supplementary figure). A computerized tomography revealed presence of right kidney above the diaphragm (Fig. 1).

Fig. 1
figure 1

CT scan without intravenous contrast material enhancement demonstrating the presence of an ectopic kidney in the intrathoracic location on the right side

Full size image

Renal ectopy is reported in 1 in 900 patients. The ectopic kidney may be pelvic, iliac, abdominal, thoracic, contra lateral, or crossed. Thoracic kidney accounts for <5 % of renal ectopia. Thoracic kidney is twice as common in men as in women. Because of the location of the liver, thoracic kidney on the right side is much less common than on the left side. The ipsilateral ureter is usually elongated and not ectopic. In most patients the suprarenal glands, spleen and renal vessels are normally situated. It is uncertain whether the delayed closure of the diaphragmatic anlage allows excessive renal ascent above the level of the future diaphragm or whether the kidney overshoots its usual position because of accelerated ascent prior to normal diaphragmatic closure. A correct diagnosis of this condition would save patients from undergoing image guided biopsies.