Presentation
Abdominal distension with concern for gastric tumor.
Patient Data
Massive hepatomegaly which is largely replaced by cysts. No solid mass.
Right kidney has multiple cysts without substantial enlargement or loss of cortex.
Left kidney is obstructed by proximal left ureteral stone with severe hydronephrosis, somewhat difficult to distinguish from the cortex which has been replaced by cysts.
Case Discussion
Typical features of autosomal dominant polycystic kidney disease, with liver disease worse than the kidneys.
The appearance of the left kidney is very interesting to compare to the right (see coronal images). The left kidney has been chronically obstructed by a proximal ureteral stone, and there is severe hydronephrosis. The cortex has been nearly completely replaced by cysts.