A CASE OF MULTIPLE CYSTIC RENAL CELL CARCINOMA RESECTED AFTER A LONG-TERM OBSERVATION FOR 6 YEARS AND 7 MONTHS

A 77-year-old woman was detected having a multiple cystic renal lesion in the lower pole of the right kidney abdominal ultrasonography at a medical checkup in April 1984. Abdominal CT revealed no malignancy and reexamination performed 6 months later offered the same findings. The patient was asymptomatic, and so was followed up under a diagnosis of multiple renal cyst. After the lapse of 6 years and 7 months (in october 1990), the patient was seen at the hospital because of right low back pain. Abdominal ultrasonography, CT, and magnetic resonance imaging disclosed an increased diameter of the renal tumor and hypertrophy of the septum in the marginal region. Abdominal angiography revealed a remarkable hypervascucularization in the tumor with a wide and narrow irregular picture. A possibility of multiple cystic renal cell carcinoma was strongly suspected. Right nephrectomy was carried out. Miltiple cystic renal cell carcinoma is a relatively rare disease, especially that capable of being followed for a long period like this case. This report also presents some notes on the etiology and therapeutic guideline in terms of changes in imagings and pathological exploration.