MULTILOCULAR RENAL CELL CARCINOMA IN A OLD LADY

A 66 year old lady presented with vague abdominal complaints- fullness on right side of the abdomen.She also complained of  bloating and dyspepsia .
On examination she was found to have ballotable lump in right lumbar region.She was subjected to routine hematological and biochemical tests and USG imaging of the abdomen.She was found to have 18 cm multicystic lesion at the inferior pole of the right kidney.
The patient was further investigated with triphasic CT scan of the abdomen.She had a 18 cm multilocal mass with peripheral enhancement and few solid areas in the cystic areas(Bosnaik grade 3).The cysts were primarily exophytic but extending upto the hilar region.
She was taken up for right radical nephrectomy.

The mass was cystic with some solid areas.It was sent for histopathological examination.

The Multicystic RCC consists of 4% of the all RCC and it is common in women ( 2/3 patients).The common age group is 50-65 years of the age group.

Histologically it is Composed of multiple cystic spaces, lined by epithelial cells with clear cytoplasm, small aggregates of clear cells within fibrous septa that do not form a solid/expansile mass.

This type of malignancy has same type of origin as that of the clear cell carcinoma but it has excellent prognosis( almost reaching to 100% at 5 years of the age).This type of cancer presents at the early stage.In the above mentioned case the stage was T2N0MO.

We are awaiting for the final histopathological examination.