Renal-adrenal fusion: A literature review starting from a unique case in an anxious achondroplasia patient

A rare renal-adrenal pathology found in an anxious and achondroplastic patient. The aim is to explore renal-adrenal fusion and to find a link between achondroplasia, anxiety and this extremely rare diagnosis, which was associated with another rare finding, an ectopic adrenal gland. Emphasis was put on the patient’s medical decision having devastating results. Only 18 medical literature reports were found up until 2023 regarding renal-adrenal fusion, a diagnosis which is made mostly incidentally, in imaging studies. The case-based analysis was focused on the patient’s background concurrent pathologies–achondroplasia and anxiety disorder, with literature insights on the renal-adrenal fusion (identified as a 1.8 × 1.7 × 0.7 cm mass on the superior renal pole) with ectopic adrenal gland. The patient’s evolution from the initial uncertain diagnosis to the rash and anxiety-induced surgical decision (against medical advice), to the final diagnosis revealed by pathology examination. The rarity of this pathology and the complexity of the patient’s case have important implications in clinical practice.