Atipical renal cyst mimicking renal cell carcinoma: Case report

Kidney atypical cystsclassified as Bosniak III or IV are suspicious of malignancy lesions. It is difficult in some cases to establish a right diagnosis based on radiological examinations and suggest appropriate therapeutic approach. A case of complicated hemorrhagic renal cyst in a 73 - years-old men is reported. The patient was admitted to our hospital for further evaluation of non specific abdominal and back pain and chronic urinary infections. Sonography showed a bilateral large cyst some of them with dense content. CT and MRI pointed to signs of malignancy in one cyst of left kidney, CT revealed Bosniak II F but MRI revealed suspicious malignant lesion. The presence of a malignant tumor in the cyst wall was suspected and nephrectomy was performed.Pathohistological examination showed evidence of inflamedhemorrhagic renal cystwithout malignancy. Atypical cysts can match a complicated cyst (infection, bleeding) or a cystic tumor. Radiological examination is often not enough for a clear differentiation false negative biopsy results in this group are commonand it may be necessary to perform a surgical treatment for an accurate diagnosis.