Multilocular cystic renal cell carcinoma a diagnostic dilemma: A case report in a 30-year-old woman
A 30-year-old female patient was referred for the management of an incidentally diagnosed right-sided cystic renal lesion. Postcontrast computed tomography (CT) scan showed a well-defined multiseptate cystic space occupying lesion in the upper pole of right kidney without any obvious lymphadenopathy in the hilum or the aorto-caval area. No mural nodule or calcification was noted in the cyst and there was no hydronephrotic change either []. There was no family history of constellation of signs or symptoms suggestive of von Hippel Lindau syndrome or renal tumors of any kind. Biochemical assessment of renal function was normal. Complete blood count and other preoperative investigations were within normal range. There were no significant findings on general and systemic examinations. Since cystic renal RCC could not be excluded a right-sided nephrectomy was performed, and the gross examination of the kidney revealed a multiloculated cyst in the upper pole of 3.5 × 3 × 3 cm dimension containing mucinous material. Neither necrotic area nor expansile nodule was appreciated [].\nHistopathological examination revealed cyst wall lined by single or multiple layers of clear cells with well-defined cytoplasmic borders and small nuclei. There were areas with alveolar arrangement of clear cells surrounded by fibrovascular septae. The tumor did not invade the renal capsule and hilar structures []. Immunohistochemistry with vimentin and EMA showed strong membranous positivity []. TNM staging and Fuhrman nuclear grading were stage T1a and grade 1, respectively.