Laparoscopic Deroofing and Excision of a Large Left Renal Cyst Mimicking Chest Infection: Case Report
Article Main Content
Background: The routine use of abdominal ultrasonography and computed tomography scan has increased the detection of asymptomatic renal cysts. Laparoscopy is usually suitable for treating large symptomatic renal cysts.
Objective: To report a case of laparoscopic treatment of a man with large left renal cyst mimicking chest infection.
Case presentation: A 75-year-old man, known hypertensive who had empirical treatment for chest infection without resolution of symptoms of cough and chest pain. He was on treatment for storage and voiding lower urinary tract symptoms with 10mg alfuzocin. Abdominal ultrasound and computed tomography scan confirmed a large left renal cortical cyst that measured 380mls. He subsequently had transperitoneal laparoscopic deroofing and excision of the renal cyst with operation finding of 300mls of straw coloured fluid excluding spillage. The immediate postoperative period was uneventful, and he was discharged home in a stable condition on the second day. The aspirate yielded no growth while the cytology report of cystic fluid was acute-on-chronic inflammation. Histology was reported as chronic pyelonephritis with cystic degeneration.
Conclusion: Large renal cyst should be considered as differential diagnosis of unresolved chest infection and is safely treated by laparoscopic deroofing and excision.
References
-
G. A. Eknoyan, “A clinical view of simple and complex renal cysts,” J Am Soc Nephrol 2009;20(9):1874-6.
Google Scholar
1
-
M. A. Bosniak, “The current radiological approach to renal cysts,” Radio 158, 1-10, 1986.
Google Scholar
2
-
T. M. Weber, “Sonography of benign renal cystic disease,” Ultras Clin 1, 15-24, 2006.
Google Scholar
3
-
T. F. Whelan, “Guidelines on the management of renal cyst disease,” Can Urol Assoc J 4(2), 98-99, 2010.
Google Scholar
4
-
M. M. Agarwal and A. K. Hemal, “Surgical management of renal cystic disease,” Cur Urol Rep 12(1), 3-10, 2011.
Google Scholar
5
-
A. A. Okeke, A. Mitchelmore and F. Keeley, “A comparison of aspiration of aspiration and sclerotherapy with laparoscopic de-roofing in the management of symptomatic simple renal cysts,” BJU Int 92, 610, 2003.
Google Scholar
6
-
C. C. Chang, J. Y. Kuo, W. L. Chan, K. K. Chen and L. S. Chang, “Prevalence and clinical characteristics of simple renal cyst,” J Clin Med Assoc 70 (11), 486-491, 2007.
Google Scholar
7
-
A. A. Mosharafa, “Prevalence of renal cysts in a Middle Eastern population: an evaluation of characteristics and risk factors,” BJU Int 1(6),736-8, 2008.
Google Scholar
8
-
M. Bisceglia, C. A. Galliani, C. Senger, C. Stallone and A. Sessna, “Renal cystic diseases: A review,” Adv Anat Pathol 13, 26–56, 2006.
Google Scholar
9
-
J. M. Kissane and M. G. Smith, “Pathology of infancy and childhood, St. Louis” C. V. Mosby Co 521, 1967.
Google Scholar
10
-
N. Terada, Y. Arai, N. Kinukawa and A. Terai A, “The 10-year natural history of simple renal cysts,” Urology 71(7), 7–12, 2008.
Google Scholar
11
-
J. Mathiew, M. Al-Mohahoon, N. Machado, R. William and K. Rahman, “Laparoscopic deroofing of large renal simple cyst causing gastric symptoms,” Sultan Qaboos Niv Med J 7(2), 139-144, 2007.
Google Scholar
12
-
N. Haque, M. Hossan and M. Uddin, “Outcome of laparoscopic deroofing of renal cyst- our experience,” Medicine today 31(2), 114-116, 2019. https://doi.org/10.3329/medtoday.v3li2.41954.
Google Scholar
13





