Presentation
Work up for flank pain.
Patient Data
A 35 mm partially exophytic cyst is present at the upper pole of the right kidney. A few fine septations and an 8mm eccentric enhancing soft tissue component are noted within the cyst. (Bosniak class IV)
A 2 mm stone is also noted in the right kidney's upper calyx.
A low attenuation hepatic lesion, measuring 20 mm in diameter, is depicted, located at the 7th hepatic segment (Couinaud`s nomenclature), revealing early peripheral nodular enhancement and showing delayed blood pool. Hemangioma is a probable diagnosis.
In addition, an 8 mm cyst is noted in the 5th hepatic segment.
Fat containing small umbilical hernia is present.
Case Discussion
Most Bosniak class IV masses are malignant and need surgical resection.
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