Benign Multilocular Cyst Research Articles

A rare case report of multiple calculi in an adult female having cystic nephroma

A benign multilocular cyst is a benign, nondysplastic, neoplastic lesion that occurs most commonly either before the age of 4 years in males or after the age of 30 years in females. The only way to determine the diagnosis of a multilocular cystic lesion is by surgical excision. We report a case of 50 years old female with chronic left flank pain. After imaging like Ultrasonography, Intravenous pyelography, patient underwent nephrolithotomy with deroofing of the cyst under the impression of multiple renal calculi within a renal cyst. Histopathological examination showed that it was a multilocular cystic nephroma, a rare benign neoplasm of the kidney. This case report discusses the epidemiology, clinical presentation, radiological features, differential diagnosis and histopathology of this neoplasm.

Pediatric Cystic Nephroma with a Review of the Literature

Cystic renal neoplasms have a broader spectrum that includes benign and malignant tumours: benign multilocular cyst, multilocular cystic renal cell cancer and cystic renal cell cancer. Gross similarities in the clinical and radiological imaging findings may cause conflict in their exact diagnosis and further treatment. Cystic nephroma is a rare, non-hereditary benign, multilocular cystic lesion of the kidney and has a prevalence in males. It has bimodal presentation more prevalent in males. In this case patient with cystic nephroma presents with a painless, progressively increasing abdominal lump, which was diagnosed and then operated. Thus, it is crucial to narrow the diagnosis by radiological imaging for preoperative planning and proper management. Abbreviations: UTI: Urinary Tract Infections, CN: Cystic Nephroma, MLCN: Multilocular Cystic Nephroma, CPDN: Cystic Partially Differentiated Nephroblastoma

Peritoneal inclusion cysts as a diagnostic and treatment challenge.

Peritoneal inclusion cysts (PICs) are benign multilocular cysts that consist of fluid localized between intraperitoneal adhesions. They usually present in women in the third and fourth decades of life with a history of prior pelvic or abdominal surgery, especially months to 20 years ago. PICs have low mortality and the potential for high morbidity. Transvaginal ultrasound with color Doppler has an important role in the differential diagnosis. Also, a very important role is played by CA 125 plasma level or use of the ROMA algorithm. But thanks to laparoscopy and the possibility of biopsy from suspicious lesions the correct diagnosis can be established. Treatment of PICs depends individually on the patient's condition, symptoms, other diseases, and desire for procreation. Among other contemplated are hormonal oral contraceptive, an image-guided aspiration, minimally invasive or open surgery. The issue of diagnosis and treatment of PICs requires the continuation of multicentre, randomized clinical trials to find and standardize effective, personalized treatments for PICs.

Multilocular Cystic Nephroma—A Brief Review

Cystic renal neoplasms can be classified as benign and malignant, consisting of multilocular cystic renal cell cancer, cystic renal cell cancer, multilocular cystic nephroma and benign multilocular cysts. The objective of this article is to summarize the clinical aspects of multilocular cystic nephroma and discuss the major similarities that provoke difficulties in proper diagnosis and treatment.

Cystic nephroma: a case report and review of the literature

BackgroundThe spectrum of cystic renal neoplasms includes both benign and malignant tumors and the order is as follows: benign multilocular cyst, multilocular cystic renal cell cancer and cystic renal cell cancer. Gross similarities among multicystic tumors of the kidney may cause conflict in the diagnosis and treatment of these lesions.ResultsWe report a 53-year old male patient who presented with a mild persistent left flank pain and a painful left renal mass. After a series of examinations including abdominal ultrasound, intravenous pyelography and computed tomography, he underwent radical nephrectomy. Microscopic examination of the resected tissue showed the typical characteristics of a cystic nephroma. Immuno-histological staining of the epithelium of the tumour with CK 19 suggested an aberrant renal tubular differentiation.ConclusionCystic nephroma is a relatively rare benign lesion of the kidney. Since 1892, only 200 cases have been reported in the international literature. The non-specific clinical findings and the poor contribution of imaging examinations make the preoperative distinction from other cystic renal neoplasias difficult. Final diagnosis can be established in the histopathological examination of the completely rejected tumor in the pathology laboratory.

A Rare Case of Bilateral Multilocular Renal Cysts

Several names have been used to describe a rare multiloculated cystic lesion in the kidney, including benign multilocular cyst, multilocular cystic nephroma, cystic nephroma and others. The abundance of names is partially attributable to an incomplete understanding of the etiology and natural history of this condition. Most authorities believe that this lesion is part of a spectrum of renal cystic disorders with multilocular cyst and cystic Wilms tumor representing the 2 extremes. Whatever the etiology, multilocular cysts have a typical radiographic appearance, are almost uniformly unilateral and are treated with curative nephrectomy. We report a unique case of bilateral multilocular renal cysts treated with bilateral partial nephrectomy. CASE REPORT A 15-month-old Hispanic boy presented with a 3-month history of progressively enlarging bilateral flank masses, and nausea, vomiting and anorexia 1 week in duration. There was no other significant medical history. Physical examination revealed blood pressure of 100/60 mm. Hg and abdominal examination demonstrated bilateral 12 to 14 cm., nontender, nonfixed, firm flank masses. Serum electrolytes, urea nitrogen, creatinine, hemoglobin and urinalysis were normal. Abdominal ultrasound and computerized tomography showed 10 X 12 cm. cystic renal masses with multiple septa (fig. 1). A rim of normal appearing renal parenchyma (right side greater than left side) was displaced inferiorly and medially. 3-Mercaptoacetyltriglycine nuclear renal scan revealed that 80% of renal function was by the right kidney. Abdominal exploration was planned but moderate hypertension developed, which was controlled with oral calcium channel blockers. Subsequently exploration was performed through a transperitoneal midline incision. The left renal mass was approached first, revealing a firm mobile cystic renal mass contiguous with the inferior pole of normal appearing renal tissue. Because of the benign appearance of this mass and bilateral involvement, a nephron sparing procedure was performed involving partial nephrectomy with renal reconstruction. The mass was completely excised en bloc (fig. 2). However, the dilated renal pelvis was opened to extrude the inferior aspect of the mass, which had herniated into the collecting system. Frozen section was consistent with a multilocular renal cyst without evidence of malignancy. Exploration of the right side revealed similar fmdings and an identical procedure was performed. Postoperatively the patient recovered well. He is currently asymptomatic and thriving, and hypertension has completely resolved. Followup renal scan and ultrasound 6 months postoperatively demonstrated excellent function of both remaining renal units with no evidence of any recurrent cystic lesions. The final pathological diagnosis was consistent with bilateral benign multilocular renal cysts.

Intraoperative Sonography for the Evaluation and Management of Renal Tumors: Experience with 100 Patients

Purpose Intraoperative sonography was used to evaluate prospectively the renal parenchyma of patients undergoing surgery for presumed renal neoplasia. Materials and Methods One surgeon (F. F. M.) evaluated 100 kidneys using a triple-head sector ultrasonic transducer (5 MHz., 7.5 MHz. and 10 MHz. with duplex Doppler imaging). The size, number, echo texture, location, and relationship of suspected lesions to the collecting system, vasculature and renal capsule were recorded. Real-time Doppler imaging was used to distinguish among renal arteries, renal veins and the collecting system. Sonography was used to delineate the extent of the tumor and presence or absence of satellite lesions. All patients were evaluated preoperatively with abdominal computerized tomography. Results Under ultrasonic guidance partial nephrectomy was done in 40 cases, radical nephrectomy in 56, unroofing of renal cysts in 3 and renal biopsy in 1. Of the patients 8 were considered candidates for partial nephrectomy but underwent radical nephrectomy after intraoperative sonography revealed more extensive tumor, especially at the renal hilum. Similarly, 3 patients with a suspected malignancy were spared nephrectomy after intraoperative sonography and frozen section analysis revealed benign multilocular cysts. All surgical margins after sonographic evaluation were negative in patients undergoing partial nephrectomy. Conclusions Intraoperative ultrasound is a useful adjunct for the dynamic evaluation of renal tumors in the surrounding environment of renal cysts, the collecting system and the renal vasculature. It is particularly beneficial in defining preoperative indeterminate renal lesions and in evaluating extrarenal structures for tumor involvement, such as the renal vein, inferior vena cava, adrenal gland and liver. Intraoperative sonography is most useful during partial nephrectomy and may improve tumor-free surgical margins. Sonography is routinely used during partial nephrectomy.

Early lesions during pancreatic carcinogenesis induced in Syrian hamster by DHPN or DOPN. I. Histologic, histochemical and radioautographic findings.

The early lesions which arise in the Syrian hamster pancreas prior to the appearance of carcinomas induced by treatment with the related carcinogens di-hydroxy-di-n-propyl nitrosamine or di-oxo-di-n-propyl nitrosamine were investigated in order to assess their roles in tumourigenesis. A sequence of events is proposed leading from ductal or ductular proliferations through regions of epithelial atypia (so-called dysplastic lesions) to carcinomas. This sequence appears distinct from that leading from ductular proliferations to benign multilocular cysts or cystadenomas. Radioautographic and histochemical evidence is presented supporting this proposal linking atypical proliferations but not cystic lesions with the induced carcinomas. Increase in the activity of glucose-6-phosphate dehydrogenase was established as being a good histochemical marker for early atypical proliferations during pancreatic carcinogenesis whereas gamma-glutamyl transpeptidase was found lacking in this respect. In addition, alteration in polysaccharide metabolism was observed during the development of the carcinomas.

Intermittent Jaundice: A Rare Complication of a Solitary Nonparasitic Liver Cyst

A case of a solitary nonparasitic liver cyst, presenting with intermittent jaundice, is described in a 61-year-old female. Twice during the condition's 19-month course deep jaundice developed, spontaneously subsiding to a state of mild icterus. Diagnosis was suggested by ultrasonography and scintigraphy, whereas retrograde cholangiography and arteriography did not contribute. At laparotomy a single large benign multilocular cyst was partially removed.