Renal Tumours Masquerading as Polycystic Disease

Renal tumours may be mistaken for polycystic kidneys, especially if the tumours are bilateral. Differentiation is important both for the consideration of surgical treatment and also for prognosis. Between 1938 and 1963, 237 patients admitted to the United Oxford Hospitals had renal tumours. Three of these were initially diagnosed as polycystic kidneys. Another patient on whom excretion urography had not been performed had bilateral renal tumours discovered at post-mortem. J. H. (U.O.H. No. 113493) when aged 23 had pulmonary tuberculosis. Three years later in 1949 he had a cerebellar haemangioblastoma removed. During the next seven years he was in good health until he had haematuria with left renal colic. At this time (1956) the kidneys were not palpable blood pressure was 150/90, and blood urea 38 mg per cent. An IVP was carried out (Fig. 1) and this was interpreted as showing polycystic kidneys (but in fact showed large space-occupying lesions in the lower poles of both kidneys with some calcification in the upper part of the right space-occupying lesion). The patient was discharged. During the next three years the blood pressure remained constant, but the kidneys became easily palpable, and the patient had four attacks of severe haematuria. A repeat pyelogram was interpreted as showing no change, but in retrospect the right kidney was probably larger. In 1962 he was again admitted to the Radcliffe Infirmary for the removal of a recurrent cerebellar haemangioblastoma.