Multilocular Cystic Nephroma. Kidney Disease Difficult To Diagnose Before Surgery: A Case Report

Abstract

Cystic nephroma is a benign renal lesion. It is a benign and rare cystic tumor of the kidney whose diagnosis needs renal specimen after nephrectomy. We report an observation of 62-year-old woman, obese with a history of type 2 diabetes who consults for left lumbar pain without hematuria. The examination found no lumbar contact or signs of urinary tract infection. The first exploration by an abdominal echotomographic shows the existence of an inferior medieval and polar lesion of 84mm of the large axis, heterogeneous with multiple anechoic zones within it of small sizes. The interpretation made by the radiologist retained 3 possible diagnoses, namely: a renal mass suspected of malignancy, a heterogeneous multicystic lesion and a hydatid cyst stage III of Gerbi. The computed tomography found a heterodyne left medieval tumor process and lower polar poorly limited with several areas of necrosis of 80mm of large diameter taking the contrast and interpreted as a malignant lesion, without hilar lymphadenopathies or retroperitoneal visible. The rest of the extension balance sheet was free of anomalies. Hydatid serology was performed and returned negative. The patient was operated on with the diagnosis of kidney cancer. The intraoperative exploration showed the existence of a left kidney increased in volume in its compartment, the accidental break-in of the latter allowed even the multilocular cystic appearance of small infracentimetric sizes of this lesion. An enlarged total nephrectomy was realized. Macroscopic examination of the part reveals a kidney carrying multiple cystic lesions arranged one against the other without nephrogenic tissue in the septic letting out a clear liquid. The pathology study showed the appearance of a multilocular cystic nephroma. Our patient is alive at 48months and in well health.