A peripelvic renal cyst resulting in clinically symptomatic ureteropelvic junction obstruction

Coggins, William S.; Hudgins, Hogan K.; Kosarek, Christopher D.; Roberts, Robyn L.

doi:10.1016/j.eucr.2017.11.001

Cited by 3 publications

(4 citation statements)

References 5 publications

(6 reference statements)

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“…Some authors have attributed the origins of PPC to lymphatic ectasia [ 8 ], whereas other authors have suggested that they are embryological remnants arising from the mesonephric duct [ 9 ]. Our histology finding of single flat epithelial cell layer suggests that PPC and the urinary tract are structures from independent origin.…”

Section: Discussionmentioning

confidence: 99%

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Symptomatic Parapelvic Cysts in Children: Anatomical and Histological Features, Diagnostic Pitfalls and Urological Management

Marret

Blanc

Balaton³

et al. 2022

JCM

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Background: Symptomatic parapelvic cysts (PPC) are rare entities. Our objective is to highlight specific features of PPC to avoid a misdiagnosis of UPJ obstruction. Methods: We retrospectively reviewed the records of children managed between 2012–2017. Results: All four patients (18 months–8 years) presented with acute renal colic with a large intra-sinusal liquid mass (42–85 mm) on ultrasound, evoking a diagnosis of UPJ obstruction. On preoperative renal scintigraphy (n = 3) there was no dilatation of the renal pelvis and ipsilateral differential function was impaired in 2. Diagnosis of PPC was suspected preoperatively in three children (CT scan (n = 1); MRI (n = 2)) and made peri-operatively (n = 1). Preoperative retrograde pyelography (n = 3) and a further intraoperative retrograde pyelography with methylene blue (n = 1) did not identify communication with the cyst. No renal pelvis was identified in two patients. De-roofing of the cyst was curative in all cases at 5 years mean follow-up (no leakage, cyst recurrence or loss of function) and all 4 patients became asymptomatic after surgery. Histology demonstrated a single flat epithelial cell layer. Renal function normalized in one patient but remained impaired in the other. Conclusion: In case of symptoms of UPJ obstruction with a medial renal liquid mass on ultrasound, PPC should be considered when no dilatated pelvis on renal scan is identified. In such cases, a complementary imaging work-up is mandatory prior to surgery.

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Section: Discussionmentioning

confidence: 99%

“…However, in rare cases, the cyst compresses the collecting system and/or renal vessels and becomes symptomatic. These symptoms usually mimic those of UPJ obstruction, which is the main differential diagnosis [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Symptomatic Parapelvic Cysts in Children: Anatomical and Histological Features, Diagnostic Pitfalls and Urological Management

Marret

Blanc

Balaton³

et al. 2022

JCM

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“…4 According to our literature search, only six articles have thus far been published on the treatment of parapelvic cysts with symptomatic obstruction. 1,5 This particularly unusual case which led to a very sudden deterioration in renal function should be further explored.…”

Section: Introductionmentioning

confidence: 99%

“…Parapelvic cysts are a relatively common pathology of the kidney which are frequently asymptomatic. 1 Parapelvic cysts, also known as renal sinus cysts, are described as cysts which form around the renal pelvis or renal sinus. 2 In 1978, Hinman et al set two requirements for a cyst to be defined as causing an obstruction, firstly the cyst must lie at or near the hilum and secondly, it must have enough turgor to overcome the pressure of the urine within the pelvis.…”

Section: Introductionmentioning

confidence: 99%

Can parapelvic cysts lead to a non-functioning kidney?

El‐Taji

Alattas

Ariyanayagam

et al. 2020

Journal of Clinical Urology

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We present a case of non-functioning kidney secondary to a parapelvic cyst in a 45-year-old male who was investigated for a single episode of self-limiting left-sided flank pain. Initial contrast-enhanced computerized tomography (CT) with delayed phases showed a 4 cm left parapelvic cyst and mild renal pelvis dilatation with no other features of obstruction. A Mercaptoacetyltriglycine (MAG3) functional scan showed 52% split function in the affected kidney and prompt drainage with no evidence of obstruction. Although completely asymptomatic after the initial episode we opted to follow him up. Eighteen months on we discovered an atrophic kidney on repeat imaging with a split function of 9% with no change in parapelvic cyst size. We propose that an intermittent silent obstruction, caused by infundibular compression deep inside the kidney, may have caused calyceal dilatation and eventual loss of function in this case. We discuss this rare presentation, review the literature and propose a follow up plan. Level of evidence: Level 5

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Parapelvic cyst: A rare cause of ureteropelvic junction obstruction in a pediatric patient managed with robotic cyst decortication

Lovin

Kirsch

2021

Journal of Pediatric Urology

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A peripelvic renal cyst resulting in clinically symptomatic ureteropelvic junction obstruction

Cited by 3 publications

References 5 publications

Symptomatic Parapelvic Cysts in Children: Anatomical and Histological Features, Diagnostic Pitfalls and Urological Management

Symptomatic Parapelvic Cysts in Children: Anatomical and Histological Features, Diagnostic Pitfalls and Urological Management

Can parapelvic cysts lead to a non-functioning kidney?

Parapelvic cyst: A rare cause of ureteropelvic junction obstruction in a pediatric patient managed with robotic cyst decortication

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