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We describe a case of transitional cell carcinoma of the renal pelvis in a horseshoe kidney with vaginal tumor as the first manifestation of remote metastasis. While the occurrence of adenocarcinoma in a horseshoe kidney appears to be no higher than in nonfused kidneys, the incidence of transitional cell carcinoma among neoplasms in horseshoe kidneys is higher. Vaginal metastasis from transitional cell carcinoma of the renal pelvis is considered extremely rare. To our knowledge, this is the first case reported of transitional cell carcinoma of the renal pelvis in a horseshoe kidney with metastasis to the vagina. The patient was successfully treated with surgery, irradiation, and chemotherapy.
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