Slideshow
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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.
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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.
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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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