Multilocular cystic renal cell carcinoma: a rare entity

Abstract

Multilocular cystic renal cell carcinoma (MCRCC) is an uncommon subtype of clear cell renal cell carcinoma that appears to have a favourable prognosis. Literature reports a very low incidence of 1-2% of MCRCC among the renal neoplasms. The first such reported case was in 1957 by Robinson. In 1998, Eble et al suggested following diagnostic criterion for MCRCC: (1) an expansile mass surrounded by a fibrous capsule; (2) interior of tumour entirely composed of cysts and septa with no expansile nodule or solid component confined to more than 10% of entire tumour and (3) septa containing aggregates of clear epithelial cells. We report a case of MCRCC in a 60-year-old male patient who presented with abdominal lump and after suspicion of renal malignancy underwent nephrectomy. The patient was perfectly well till last follow-up of 3 months postoperatively.

Figure 1

(A) CT abdomen: Well-defined and marginated round hypodense lesion involving whole of kidney with evident internal septations and few small necrotic areas. (B) Gross: Well-encapsulated, multiseptate tumour mass with variegated appearance involving upper and middle lobes of the kidney.

Figure 2

Multilocular multicystic renal cell carcinoma with thin fibrous septa lined with clear cells with grade 1/2 nuclei (inset).