Renal epithelial and stromal tumor with a multiple cystic lesion localized in the upper portion of the right kidney
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CASE REPORT
Renal epithelial and stromal tumor with a multiple cystic lesion localized in the upper portion of the right kidney Masato Sawamura1 · Naoki Sawa1,3 · Masayuki Yamanouchi1 · Daisuke Ikuma1 · Akinari Sekine1 · Hiroki Mizuno1 · Tatsuya Suwabe1 · Junichi Hoshino1,3 · Kei Kono2 · Keiichi Kinowaki2 · Kenichi Ohashi2 · Yoji Nagashima4 · Yoshifumi Ubara1,3 Received: 3 August 2020 / Accepted: 15 October 2020 © The Author(s) 2020
Abstract A 60-year-old Japanese woman was admitted because of the polycystic mass with right flank pain localized in the upper portion of the right kidney. Right nephrectomy was performed because the mass lesion had continuously increased in size over the past 10 years. A surgical specimen showed histology consistent with a mixed epithelial and stromal tumor, which is closely related to multilocular cystic nephroma, and was diagnosed by a defined capsule between the cystic mass lesion and normal renal tissue by CT and MRI, and histology. Localized renal cystic disease that does not have a capsule was excluded from differential diagnosis. Keywords Unilateral renal cystic disease · Multilocular cystic nephroma · Renal epithelial and stromal tumor · Autosomal dominant polycystic kidney disease Abbreviations ADPKD Autosomal dominant polycystic kidney disease CT Computed tomography DTPA scan Diethylenetriaminepentacetate scan, LRCD, localized renal cystic disease MCN Multilocular cystic nephroma MEST Mixed epithelial and stromal tumor MRI Magnetic resonance imaging REST Renal epithelial and stromal tumor URCD Unilateral renal cystic disease EMA Epithelial membrane antigen ER Estrogen receptors * Masato Sawamura [email protected] * Yoshifumi Ubara [email protected] 1
Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 1C‑1, Takatsu, Kawasaki, Kanagawa 212‑0015, Japan
2
Department of Pathology, Toranomon Hospital, Tokyo, Japan
3
Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
4
Department of Surgical Pathology, Tokyo Women’s Medical University, Tokyo, Japan
PR Progesterone receptors VATS Video-assisted thoracoscopic surgery
Introduction Localized renal cystic disease (LRCD) has been reported; cysts form in only one kidney and not in other organs, and patients do not have a family history of cystic disease, unlike autosomal dominant polycystic kidney disease (ADPKD). Two types of LRCD have been reported: segmental renal cystic disease, which involves just one part of a kidney, and unilateral renal cystic disease (URCD), which involves a whole kidney [1, 2]. Here, we encountered a polycystic mass only in the upper portion of the right kidney in a 60-year-old female patient, and URCD/LRCD has been considered first diagnosis, but finally localized multilocular cystic nephroma (MCN) became definitive diagnosis. Differential diagnosis of two type of polycystic diseases including URCD/LRCD and MCN will be discussed clinically, pathologically and by diagnostic image on this issue.
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