A 53-year-old female patient admitted to the urology clinic with left flank pain without renal colic or macroscopic haematuria. No mass was detected on bimanual examination on left costovertebral triangle. Abdominal CT scan showed decreased renal parenchymal thickness of upper pole of the left kidney. Complex cystic mass with coarse calcifications and pathological contrast involvement, and a mass of 4x3 cm in size was detected on lateral aspect of the upper pole of the left kidney (Bosniak category III) [ As the presented lesion was located away from the collecting system and vascular structures, open nephron sparing surgery was performed successfully. On gross pathological examination the specimen was 4x4x1 cm in size and macroscopically encapsulated.
ABSTRACTMulticystic nephroma (MCN) is relatively a rare, nongenetic and benign lesion of the kidney which has a bimodal distribution. The congenital form is commonly seen under the age of 2. Adult-onset MCN is more often seen in women, especially in post menopausal females. The aetiopathogenesis of MCN is still unknown. Ovarian-like stroma of the tumour indicates the tumour originates from the mullerian tissue of the kidney. Hormonal theory is suggestive as the stroma of the tumour is positive for estrogen and progesteron. Preoperative diagnosis of MCN is difficult. Surgical approach is recommended both for the histological diagnosis and the treatment of the disease. We here present a 53-year-old female patient with MCN admitted to the urology clinic with left flank pain treated successfully with partial nephrectomy. No recurrence was noted after six months of clinical and radiological follow-up.On cut section, multicystic white lesion with calcified areas was seen [Table/ Fig-1f]. The content of the cysts was serum-like and lucid. No macroscopic haemorrhage and necrosis was seen in the specimen. Microscopically, the specimen showed enlarged cystic structures. Cysts were lined with flattened epithelial cells arranged in a single row and had a hobnail appearance. They were surrounded by the cellular and fibroblastic stroma, histologically similar to ovarian stroma and the homogenous and eosinophilic areas resembling to corpus luteum. Enlarged tubules were surrounded by mature adipocytes and calcified areas. No blastemal cells or immature epithelial elements were seen. No epithelial cells with clear cytoplasm were seen. Both ovarian like stroma and corpus luteum like areas were positive for estrogen receptor (ER) and negative for progesterone receptor (PR). They were also positive for cytoceratine (CK19), epithelial membranous antigen (EMA) and CD15 and negative for CD10 [