Two malignant tumors in a polycystic kidney

Nephroblastoma and end-stage renal failure with bilateral cystic kidneys

A child of 10 years 5 months presenting with chronic renal failure had bilateral cystic kidneys. Biopsy of a right lower-pole solid mass revealed nephroblastoma. At bilateral nephrectomy, both kidneys were both replaced by variable-sized cysts with a unifocal nephroblastoma on the right. Renal failure with nephroblastoma is uncommon and is usually either a manifestation of the Drash syndrome or a complication of chemotherapy. The need to assess both kidneys in a child with any other renal abnormality in addition to a renal mass should always be considered.

Acquired cystic disease of the kidney and renal cell carcinoma on long term hemodialysis four surgical cases of young adults in Japan

Four surgical cases of acquired cystic disease of the kidney in the third decade are reported, which include renal cell carcinoma in three patients and multiple adenomas and cystadenomas in all patients. The intervening parenchyma of these kidneys was disorganized as end stage kidney and numerous cysts were found in both kidneys. Some of the cysts were lined by hyperplastic epithelium consisting of clear and granular cells arranged in piled up and papillary fashion. These cysts were diagnosed as cystadenoma. Multiple solid adenomas of a 28-year-old male on hemodialysis for 6 years were of various size as if arranged in developing stage of the growth. Summing up all cases included in the literature, the mean duration of hemodialysis of the cases with renal tumor was 5.2 years, while 2.9 years without tumor. With increase of duration of hemodialysis, acquired cystic disease of the kidney is exposed to a high risk of developing malignancy.

Renal carcinoma associated with polycystic kidneys: occurrence after chronic hematuria and hypertension

A case of polycystic kidneys associated with renal cell carcinoma in a 62-year old man is described. The concept that hematuria in patients with polycystic disease should not give rise to suspicion of malignancy if hypertension is present is questioned.

Polycystic renal disease--occurrence of malignant change and role of nephrectomy in potential transplant recipients

28 cases of malignant renal neoplasms in patients with polycystic kidneys are reviewed from the literature and 2 new cases are reported. The difficulty in diagnosing this malignant change together with the increased survival of patients with polycystic kidneys on dialysis and transplant programmes leads to the recommendation that all such patients should be considered for nephrectomies. The reasons for this recommendation and its advantages and disadvantages are discussed.

Coexisting avascular lesions and renal cell carcinoma

An analysis of 99 cases of coexisting renal avascular lesions and renal cell carcinoma suggests that: (1) a direct pathogenetic relationship exists in the majority; (2) the cyst-related carcinoma tends to occur at an earlier age; (3) angiography alone is not reliable for the diagnosis of an apparently benign renal mass, and (4) individuals with polycystic kidneys share at least an equal risk of renal carcinoma as the general population.

Bilateral renal carcinoma associated with polycystic kidneys

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