Successful management of a mixed epithelial and stromal renal tumor masquerading as lower pole renal cyst: A laparoscopic deroofing approach

UroPrecision Pub Date : 2024-03-26 DOI:10.1002/uro2.39
A. M. Mukendi, Emelia K. C. de Heer‐Menlah Phaladi, Charles E. Mathye
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Abstract

Renal cysts are common in clinical practice, but some may harbor rare pathological entities such as mixed epithelial and stromal tumors (MEST). Imaging studies are crucial for accurate diagnosis. While laparoscopic deroofing is an established approach for symptomatic renal cysts, encountering MEST within a cyst is uncommon.We present the case of a 37‐year‐old female who presented with persistent left flank pain. Imaging revealed a large renal cyst in the lower pole of the left kidney, classified as Bosniak 2. Despite analgesia, the patient's symptoms persisted, leading to a laparoscopic deroofing procedure. Histopathological examination postprocedure revealed a MEST. The patient reported complete resolution of symptoms at the 3‐month follow‐up.This unique case presents the successful identification and surgical management of a MEST masquerading as a lower pole renal cyst through laparoscopic deroofing. It also contributes to the existing literature by highlighting the importance of considering rare pathological entities in the evaluation of renal cysts and the value of laparoscopic techniques in their management.
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成功治疗伪装成下极肾囊肿的上皮和间质混合肾肿瘤:腹腔镜切除法
肾囊肿在临床上很常见,但有些囊肿可能隐藏着罕见的病理实体,如上皮和间质混合瘤(MEST)。影像学检查对准确诊断至关重要。虽然腹腔镜切除术是治疗无症状肾囊肿的成熟方法,但在囊肿内发现 MEST 的情况并不常见。影像学检查显示,左肾下极有一个巨大的肾囊肿,分类为波什尼亚克 2 型。尽管采取了镇痛措施,但患者的症状仍持续存在,因此接受了腹腔镜下肾脏切除术。术后的组织病理学检查显示患者患有 MEST。这个独特的病例展示了通过腹腔镜切除术成功识别并手术治疗了伪装成下极肾囊肿的 MEST。这例独特的病例介绍了通过腹腔镜切除术成功鉴别并手术治疗了伪装成下极肾囊肿的 MEST,同时还强调了在评估肾囊肿时考虑罕见病理实体的重要性以及腹腔镜技术在治疗中的价值,为现有文献做出了贡献。
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