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Journal of Radiological Review 2020 July-August;7(4):318-24

DOI: 10.23736/S2723-9284.20.00047-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English, Italian

Unusual presentation of a cystic clear cell renal cell carcinoma mimicking a renal cyst

Dario GIAMBELLUCA 1 , Alessio PELLEGRINELLI 2, Paolo CABASSA 1

1 Department of Radiological Sciences, ASST Franciacorta, Azienda Ospedaliera M. Mellini, Chiari, Brescia, Italy; 2
Department of Pathology, ASST Franciacorta, Azienda Ospedaliera M.Mellini, Chiari, Brescia, Italy


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Renal cell carcinoma (RCC) still remains a relatively common neoplasia. It can have various and ambiguous type of presentation. Cystic RCC occurs infrequently. Radiology plays a crucial role in the diagnosis, management, surveillance and choice of renal lesions that need treatment. However, the imaging features of cystic RCC do not facilitate an accurate diagnosing, thus it is commonly misdiagnosed before the operation as a simple renal cyst.
Although cytological examination can assist diagnosis through observing abnormal cystic fluid and cells, this technique has a low positive rate, limiting its use in clinical settings. Surgical pathological examination remains the gold standard and is mandatory for the diagnosis and further management of cystic RCC. A case of cystic renal lesion presenting with left lumbar pain and fever, discovered by ultrasound and CT and successfully managed with partial nephrectomy, is reported. At first, it was formulated a diagnostic hypothesis of infected complex renal cyst. The lesion was then histologically characterized as cystic RCC.


KEY WORDS: Carcinoma, renal cell; Kidney diseases, cystic; Cysts; Ultrasonography; Tomography, X-ray computed

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