Case Report: Ovarian Cyst in a Woman With Congenital Unilateral Renal Agenesis in Nigeria

Congenital anomalies of the kidney and urinary tract (CAKUT) are among the most common birth defects worldwide and contribute significantly to pediatric renal failure and adult nephropathy. Unilateral renal agenesis (URA), a key subset of CAKUT, occurs in approximately 1 in 1,000 live births and results from the failure of the ureteric bud to induce metanephric differentiation during fetal development, leading to the complete absence of one kidney and its ureter. URA can present as an isolated anomaly or in combination with other congenital abnormalities, particularly affecting the genital tract due to their shared embryological origin. In females, URA has been associated with Müllerian duct anomalies, including uterine agenesis, uterine hypoplasia, unicornuate uterus, and ovarian cyst formation. These associations may remain asymptomatic until adolescence or adulthood, manifesting as menstrual irregularities, infertility, or incidental findings during imaging for unrelated medical conditions. The prevalence and clinical impact of these combined anomalies are not well documented, especially in low-resource settings such as sub-Saharan Africa, where access to advanced imaging and specialist care is limited. This case report highlights a Nigerian female patient presenting with an ovarian cyst in the context of unilateral renal agenesis, emphasizing the importance of considering genitourinary associations in patients with congenital renal anomalies. Awareness of such associations is crucial for timely diagnosis, appropriate management, and counseling regarding potential reproductive and renal implications. Improved documentation and reporting of such cases can enhance understanding of the epidemiology, guide clinical evaluation, and inform healthcare strategies in resource-limited settings