Giant renal cyst. Presentation of a case

Abstract

Frequently, cysts develop in the kidney. Among the diversity of renal cysts, the simple one could be located inside the kidney or in its surface and may be single or multiple, unilateral or bilateral, and more frequent in the left kidney. Generally they are asymptomatic and can reach a great size, called giant cysts. We present a patient aged 66 years, entering the hospital with lumbar pain of one year that gets worse despite the medical treatment for a presumed sacrolumbal  pain. It was found a remarked increase of the abdomen volume, mainly in the direction of the upper hemiabdomen and it feels a big tumoral mass filling the totality of the upper abdomen, renitent and no painful. An abdominal computer tomography was carried out, finding a multi partitioned hypodense image filling all the left hemiabdomen with displacement of loops, left kidney and psoas muscle. We arrived to the conclusion that it was a giant multi partitioned cyst of the left kidney.  A left paramedian supra and infra umbilical laparotomy was carried out finding a renal cyst of the upper pole of the left kidney surpassing media line and displacing aortal artery to the right of the spinal column. A left nephrectomy was carried out. It is rare a simple renal giant cyst surpassing the media line and compressing so many intra abdominal organs; this is a fact scarcely described in the medical literature. The surface physical examination restricted to the organ producing the symptoms that motivate the consultation, interferes the precocious diagnosis of many diseases as it is shown in this patient. This is one of the most frequent mistakes committed when applying the clinical method.