Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Author Reply
Book Review
Brief Communication
Case Report
Case Series
Clinical Case Report
Clinicopathological Conference
Commentary
Corrigendum
Editorial
Editorial – World Kidney Day 2016
Editorial Commentary
Erratum
Foreward
Guidelines
Image in Nephrology
Images in Nephrology
Letter to Editor
Letter to the Editor
Letters to Editor
Literature Review
Notice of Retraction
Obituary
Original Article
Perspective
Research Letter
Retraction Notice
Review
Review Article
Short Review
Special Article
Special Feature
Special Feature - World Kidney Day
Systematic Review
Technical Note
Varia
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Author Reply
Book Review
Brief Communication
Case Report
Case Series
Clinical Case Report
Clinicopathological Conference
Commentary
Corrigendum
Editorial
Editorial – World Kidney Day 2016
Editorial Commentary
Erratum
Foreward
Guidelines
Image in Nephrology
Images in Nephrology
Letter to Editor
Letter to the Editor
Letters to Editor
Literature Review
Notice of Retraction
Obituary
Original Article
Perspective
Research Letter
Retraction Notice
Review
Review Article
Short Review
Special Article
Special Feature
Special Feature - World Kidney Day
Systematic Review
Technical Note
Varia
View/Download PDF

Translate this page into:

Letter to the Editor
ARTICLE IN PRESS
doi:
10.4103/ijn.ijn_235_23

An Isolated Infected Retroperitoneal Enteric Duplication Cyst Mimicking Renal Carcinoma: A Rare Presentation

Department of Pathology, Dharamshila Narayana Superspeciality Hospital, New Delhi, India
Department of Radiology, Max Superspeciality Hospital, Saket, New Delhi, India
Corresponding Author: Dr. Prachi, Junior Consultant, Department of Pathology, Dharamshila Narayana Superspeciality Hospital, New Delhi, India. E-mail: prachipath123@gmail.Com
Licence
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

How to cite this article: Prachi, Sharma G, Agarwal A. An Isolated Infected Retroperitoneal Enteric Duplication Cyst Mimicking Renal Carcinoma: A Rare Presentation. Indian J Nephrol. doi: 10.4103/ijn.ijn_235_23

Dear Editor,

Enteric duplication cysts (EDCs) are rare congenital anomalies, which occur anywhere between mouth and rectum.1 In 1961, Melish and Koop defined “enteric duplications” as spherical or tubular structures that possess a mucosal lining characteristic of one or more portions of the alimentary tract supported by muscular and serosal layers.2 In rare cases, duplication cysts are isolated from the digestive tract and have a unique blood supply, known as Isolated Enteric duplication cysts (IEDCs)3 The incidence rate of EDCs is 1 in every 4,000 to 5,000 live births.4

Herein, we report this rare case in 13-year-old female, who presented with left flank pain associated with fever and vomiting since a month. Her hematological, liver function test, renal function test, and urinalysis were within normal limits. She was put on a course of antibiotics, but her symptoms persisted. Ultrasound [Figure 1a], contrast MRI abdomen [Figure 1b] and CT urography [Figure 1c] revealed a partly exophytic complex left renal cystic lesion at its upper pole showing solid enhancing areas and coarse calcification, with possible differentials being mitotic etiology or infected cyst. In view of the above mentioned imaging findings, histopathological examination was advised to rule out malignancy. Laparoscopic left nephrectomy was done. Grossly specimen, measured 8 × 4 × 3 cm, showed an ulcerated cystic gray white lesion at upper pole of kidney [Figure 1d]. Microscopically, it revealed mucosal lining with underlying smooth muscle associated with marked inflammation [Figure 1e and f]. Features were consistent with inflamed retroperitoneal isolated EDC with organizing abscess and unremarkable renal parenchyma. In this case, preoperatively, it mimicked renal cell carcinoma, which is an unusual presentation of this rare anomaly; hence, a definitive diagnosis was made by constellation of clinical, imaging, and most crucial histopathological examination to come to a final conclusion.

Figure 1:
(a) Ultrasonography showing thick-walled lobulated cystic lesion at upper pole of left kidney with internal echoes and echogenic foci, suggestive of complex cystic lesion; (b) MRI abdomen: Thin-walled cystic lesion at the upper pole of left kidney with heterogeneously enhancing solid component; (c) CT urogram: Complex partly exophytic left renal cystic lesion at the upper pole with solid enhancing areas and coarse calcification. (d) Gross photograph of nephrectomy specimen showing an ulcerated cystic lesion at upper pole of the left kidney, (e) Microphotograph showing colonic mucosa with underlying smooth muscle component along with inflammation (hematoxylin and eosin stain: ×100), (f) Microphotograph showing colonic mucosa with underlying smooth muscle and inflammation (hematoxylin and eosin stain: ×400).

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Financial support and sponsorship

Nil.

References

  1. , , , , , , et al. Gastric duplication cysts of the pancreas: Clinical presentation and surgical management. Eur J Pediatr Surg. 2011;21:402-4.
    [CrossRef] [PubMed] [Google Scholar]
  2. , . Clonical manifestations of duplication of the bowel. Pediatrics. 1961;27:397-407.
    [CrossRef] [PubMed] [Google Scholar]
  3. . Chapter 88-alimentary tract duplications In: , , , , , eds. Pediatric Surgery (6th ed). Philadelphia: Mosby; . p. :1389-98.
    [CrossRef] [Google Scholar]
  4. . Potter’s Pathology of the Fetus, Infant and Child (2nd). Amsterdam, The Netherlands: Elsevier; .
    [Google Scholar]

Fulltext Views
48

PDF downloads
21
View/Download PDF
Download Citations
BibTeX
RIS
Show Sections