A 43-year-old housewife, allergic to iodinated contrast agent and smoker of 1 packet of cigarettes a day, hysterectomised and right hysterectomised for endometriosis.
The patient was being studied by the haematology department for isolated leukocytosis; an abdominal ultrasound scan was performed, finding a destructured left kidney with cystic images or hydronephrosis, and she was referred to our clinic.
On interrogation, she refers to a 27-day admission, when she was 12 years old, to another hospital for lumbar pain with haematuria, without knowing the diagnosis. She also reported occasional mechanical low back pain with moderate asthenia.
Physical examination: no findings.
Complementary tests: haemogram with slight leukocytosis without deviation of the leukocyte formula, the rest being normal, biochemistry and coagulation normal.
MAG-3-Tc-99m renogram: normal right kidney. Heterogeneous uptake in the left kidney with superior calyceal dilatation, retention in the left upper pole presenting a slowing of the excretory curve whose activity disappears in late images.
CT scan without contrast: left upper polar renal cystic mass of approximately 12 cm maximum diameter displacing pancreas and spleen. Internally it was made up of multiple cysts of different sizes and had heterogeneous internal septa, some of them thick and irregular, suggestive of cystic multinodular cystic nephroma or cystic renal cell carcinoma.
It was decided to perform a nephrectomy with left lymphadenectomy. The anatomopathological study of the specimen showed a kidney with a multicystic tumour measuring 9x10 cm that occupied most of the kidney. The contents of the cyst are amber without the presence of solid parts or adherence of the tumour to the capsule. The cavities are lined by a simple epithelium with frequent cells with a "tack" morphology. The intercellular stroma is fibrous. Well-demarcated lesion of preserved renal parenchyma. Pathological diagnosis of benign multilocular cystic tumour of the kidney.