Multilocular renal cystic disease in children

Multilocular cysts of kidney. A study of 29 patients and review of literature

Multilocular renal cyst is a distinct renal tumor whose gross external appearance and absence of normal renal tissue within the septa of loculi distinguish it clearly from other renal cystic lesions. Interlocular septa may contain either (1) fibrous tissue alone or (2) embryonic tissue separating adjacent loculi. Of 29 patients with multilocular renal cysts, 24 underwent a renal-sparing procedure, and only 5 had radical nephrectomy. None of the histologic specimens showed evidence of immature renal tissue or neoplasia. Patients were followed from three months to eight years (mean, 39 months), and no evidence of local recurrence or metastatic disease was found. Because it is difficult to distinguish multilocular renal cyst from cystic Wilms tumor and multicystic clear cell carcinoma on the basis of imaging studies alone, surgical intervention is the only effective method to differentiate multilocular renal cyst from a malignant lesion of the kidney.

Multilocular renal cyst associated with transposition of the inferior vena cava and malrotation of the bowel

A case is presented of an adult male patient with a heavily calcified multilocular renal cyst (Permann's tumor), transposition of the inferior vena cava and reversed rotation (malrotation) of the bowel. Because of the synchronous embryological development of the forementioned structures, a possible congenital etiology of the multilocular renal cyst is suggested.

Multilocular cyst of kidney

We describe a child with a multilocular renal cyst who presented with a renal mass and pain due to haemorrhage into the cyst. This type of presentation has not been reported previously.

Diagnostic workup and treatment of multilocular cystic kidney. Difficulties in differential diagnosis

The diagnostic pitfalls of multilocular renal cystic disease are illustrated by the medical histories of 4 patients. Although ultrasonography and CAT scans are considered reliable diagnostic methods in cystic renal disease, in the 4 cases reported these methods could not give the correct diagnosis. In multilocular cystic disease, segmental excision is the preferred treatment, if frozen section does not show malignancy. However, frozen section done intraoperatively can give misleading results, as illustrated in these cases.

Bilateral multilocular renal cysts

Multilocular renal cystic disease is a rare, benign condition thought to occur unilaterally. We report a case of asynchronous, bilateral multilocular renal cystic disease, which suggests that unilaterality is not essential for diagnosis of this lesion.

Multilocular cyst of kidney with embryonic tissue

A case of a multilocular cyst in a child is documented, and a brief review of reported cases of multilocular cysts in pediatric age groups is presented. These cases can be divided into two subgroups based on the presence or absence of embryonic tissue within the cysts. The significance of this embryonic tissue with regard to histogenesis and prognosis of the multilocular cysts is discussed.

Adenocarcinoma in multilocular renal cyst

The fifth case of a patient with a multilocular cystic nephroma with an associated adenocarcinoma is reported. The histology of the tumor and biochemical analysis of the cyst fluid are presented and the literature summarized.

Multilocular cystic disease of kidney

A case of multilocular cyst of the kidney with calcification is presented and pertinent literature is reviewed. With our present knowledge, a multilocular cyst cannot be clearly differentiated from a malignant renal tumor by preoperative evaluation. Conservative surgery with operative evaluation of the lesion is suggested.

Nephroblastoma occurring in a multilocular cystic kidney

A case of a nephroblastoma in a multilocular cystic kidney in a 5-year-old child is reported and the related literature is reviewed. Because of the unreliability of preoperative and intraoperative diagnostic modalities in identifying a coincidental nephroblastoma nephrectomy is recommended for multilocular cystic disease of the kidney in children.

Multilocular cysts of kidney: a diagnostic dilemma

Multilocular cyst of the kidney is a rare pathologic entity occurring in both children and adults. Although diagnosis cannot be firmly established preoperatively, the use of intravenous pyelography, angiography, ultrasonography, and delta scan may aid in its diagnosis. Because of the difficulty in accurate diagnosis and the documented association with renal neoplasia, we recommend exploration and possible nephrectomy as the treatments of choice.

Multilocular cystic kidney

Two cases of multilocular cystic kidney are reported. Current concepts of pathogenesis are reviewed. Treatment by total nephrectomy is advocated when the contralateral kidney is normal; partial nephrectomy should be reserved for those cases in which the contralateral kidney has reduced function or is absent.