Cystic Enhancing Renal Mass in a Young Adult - Renal and Urology News

Cystic Enhancing Renal Mass in a Young Adult

Slideshow

  • Computed tomography scan demonstrating 8 cm left Bosniak IV cystic mass.

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    Computed tomography scan demonstrating 8 cm left Bosniak IV cystic mass.

  • Computed tomography scan demonstrating 8 cm left Bosniak IV cystic mass.

    Slide

    Computed tomography scan demonstrating 8 cm left Bosniak IV cystic mass.

  • Gross pathologic examination of the left radical nephrectomy specimen, demonstrating cystic nephroma in the lower pole on the right side of the image.

    Slide

    Gross pathologic examination of the left radical nephrectomy specimen, demonstrating cystic nephroma in the lower pole on the right side of the image.

A 32-year-old otherwise healthy man was incidentally found to have an 8 cm left lower pole enhancing cystic mass. He underwent left robotic exploration for possible nephron-sparing surgery. The intraoperative appearance of the mass was suggestive of a high-grade lesion, and a radical nephrectomy was performed. Final pathology demonstrated a benign tumor.

This case was prepared by Alexander Kutikov, MD, of Fox Chase Cancer Center in Philadelphia.REFERENCEGranja MF, O'Brien AT, Trujillo S, et al. Multilocular cystic Nephroma: A systematic literature review of the radiologic and clinical findings. AJR Am J Roentgenol. 2015; 205:1188-1193.Answer: B...

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This case was prepared by Alexander Kutikov, MD, of Fox Chase Cancer Center in Philadelphia.

REFERENCE

Granja MF, O’Brien AT, Trujillo S, et al. Multilocular cystic Nephroma: A systematic literature review of the radiologic and clinical findings. AJR Am J Roentgenol. 2015; 205:1188-1193.

Answer: B

Cystic nephromas are rare benign renal lesions most often found in young boys and adult women, making this particular case unusual. Despite being considered a pediatric tumor, over 50% of cystic nephromas are diagnosed in patients older than 10 years, with a median age at presentation being in late 40’s/early 50’s in this group. Cystic nephromas generally appear as large (median size 9 cm) Bosniak III and IV cystic tumors on cross-sectional imaging and are largely indistinguishable from malignant counterparts radiographically.

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