Residency Program - Case of the Month
June 2010 - Presented by Nelson Velasco, M.D.
The patient is a 56-year-old female with no significant past medical history who presented to her PMD with on going non-specific microscopic hematuria. A cystoscopy performed 10 years prior was negative. A CT ordered for further evaluation showed a 5 cm complex cyst in the right kidney at the upper pole and extending downward into the hilum. Upon referral to UC Davis Health System, an abdominal ultrasound showed a 4.5 cm isoechoic mass of the upper pole of the right kidney probably representing a hemorrhagic cyst. A cystoscopy was also perfomed and was negative. The patient underwent a partial right nephrectomy.
The partial nephrectomy specimen measured 6.5 x 6 x 4 cm and was predominantly cystic. Upon sectioning a small yellow nodule measuring 1.2 x 1 x 1.2 cm was noted within a background of hemorrhagic and necrotic material. The nodule was grossly 0.8 cm from the parenchymal margin.