Adult Multicystic Nephroma: Case Report and Review of the Literature

Abstract

Multicystic nephroma (MCN) is relatively a rare, nongenetic and benign lesion of the kidney which has a bimodal distribution. The congenital form is commonly seen under the age of 2. Adult-onset MCN is more often seen in women, especially in post menopausal females. The aetiopathogenesis of MCN is still unknown. Ovarian-like stroma of the tumour indicates the tumour originates from the mullerian tissue of the kidney. Hormonal theory is suggestive as the stroma of the tumour is positive for estrogen and progesteron. Preoperative diagnosis of MCN is difficult. Surgical approach is recommended both for the histological diagnosis and the treatment of the disease. We here present a 53-year-old female patient with MCN admitted to the urology clinic with left flank pain treated successfully with partial nephrectomy. No recurrence was noted after six months of clinical and radiological follow-up.

Keywords: Benign; Ovarian like stroma; Postmenapausal female.

[Table/Fig-1a-e]:

Abdominal CT Transverssection views

[Table/Fig-1f]:

Macroskopic view

[Table/Fig-2a-d]:

(a) Ovarian like stroma is seen around cystic structure H&E X100 (b) Diffuse corpusluteum like areas in the tumour stroma H&E X100 (c) Positive reaction for estrogen receptor in the ovarian like stroma cystic structures ER X100 (d) Ovarian like stroma negative for progesterone receptor PR X100

[Table/Fig-3a-f]:

(a) Cystic structures lined with flattened epithelial cells are seen in the fibro blastik stroma H&E X40 (b) Cysts are lined with hobnail epithelial cells H&E X200 (c) Cysts are lined with hobnail epithelial cells H&E X400 (d) Epithelial cells lined cystic structures are positive for CD 15 resemble to mature renal tubules CD15X100 (e) Epithelial cells lined cystic structures are positive for CK 19 resemble to mature renal tubules CK 19X100 (f) Epithelial cells lined cystic structures are positive for EMA resemble to mature renal tubules EMAX 100