Presentation
Right flank pain and gross hematuria for 1 week. No fever, anorexia or weight loss.
Patient Data
Findings: A well-defined heterogeneous, predominantly cystic lesion measuring approximately 3.8 x 4.9 cm is seen at the medial aspect of mid pole of right kidney. Multiple thick enhancing septae are seen in the lesion. No calcifications or focal solid component is seen in the lesion. Renal vessels and IVC are patent and well opacified. No significant locoregional lymphadenopathy or distant metastases are noted. A small non-enhancing hypodense lesion measuring approximately 7 mm is seen in segment 8 of the liver which is likely a hepatic cyst. Impression: Bosniak type III right renal lesion.
Case Discussion
Procedure: Right nephrectomy.
Diagnosis: Multilocular cystic renal neoplasm of low malignant potential (previously known as multilocular cystic renal cell carcinoma). FUHRMAN nuclear grade: 1-2. Tumor size: 3.5 cm in maximum dimension. Tumor is confined to the kidney but reaches very close to the outer surface of the capsule. Lymphovascular space invasion: Not identified. Excision margins: Negative. Pathologic stage: pT1a,Nx,Mx.
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