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Case of the Week 578


What is the most likely diagnosis?

  • 36 year-old female with flank pain



Left Kidney-Contrast-Enhanced CT Urogram

  1. Hydronephrosis
  2. Renal Cell Carcinoma
  3. Xanthogranulomatous Pyelonephritis
  4. Cystic Nephroma
  5. Staghorn calculus

Additional Image - Axial contrast-enhanced CT of the upper abdomen

 

Additional Images

 


Axial contrast-enhanced CT of the upper abdomen


Answer:

 

4.Cystic Nephroma

 

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Cystic Nephroma

General Considerations

  • Rare, unilateral multi-loculated cystic tumor lacking blastemal elements
  • Solitary, well-circumscribed
  • Non-communicating fluid-filled locules, surrounded by thick, fibrous capsule
  • Do not connect to the collecting system
  • Usually quite large (mean 7.6 cm by 9.7 cm)
  • Most common in lower pole
  • Bimodal occurrence
    • Affects males more often in childhood ( 3 months-4 years)
      • 50% cystic nephromas and 50% CPDN (see below)
    • Females more frequently in adulthood (>30)

MORE . . .

 


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This Week

36 year-old female with flank pain
 
 
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Recognizing normal and  key abnormal intestinal gas patterns, free air and abdominal calcifications
 
Recognizing the parameters that define a good chest x-ray; avoiding common pitfalls
 
How to recognize the most common arthritides




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LearningRadiology.com
is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.