Epidermoid cyst in the kidney

Intrarenal epidermoid cyst mimicking a cystic renal cell carcinoma: A case report and review of literature

Key Clinical Message

This case highlights the diagnostic pitfalls that can occur when evaluating complex cystic renal masses. Distinguishing epidermoid cysts from renal cell carcinoma is difficult but imperative to guide conservative management when appropriate, avoiding unnecessary nephrectomy.

Abstract

Renal epidermoid cysts are extremely rare, with only 12 cases reported in the literature. Their radiographic features often resemble cystic renal cell carcinoma, frequently prompting unnecessary nephrectomy. A 64-year-old man with a history of nephrolithiasis presented with left flank pain and hematuria. Imaging revealed a complex cystic renal mass suspicious for renal cell carcinoma. Following left radical nephrectomy, histopathology examination revealed a benign epidermoid cyst. Renal presentation of epidermoid cyst poses unique diagnostic and therapeutic challenges. Possible pathogenesis includes ectopic epidermal implantation during embryogenesis or squamous metaplasia following chronic irritation or deficiency. Radiographic distinction from concerning entities like renal cell carcinoma is difficult but imperative to avoid extensive surgery. This case highlights the diagnostic pitfalls and management considerations for renal epidermoid cysts. Additional study of clinical and imaging factors that distinguish epidermoid cysts from renal cell carcinoma can guide conservative management when appropriate, avoiding unnecessary nephrectomy for benign disease.

Intra renal epidermal cyst simulating a renal tumor: A case report

Epidermoid cyst is an unusual and very rarely described lesion in the kidney. We report the case of a 45-year-old woman with no known pathological history who presented with right flank pain accompanied by macroscopic hematuria. The physical examination was unremarkable. The CT scan evoked a malignant tumor in front of a right renal mass with irregular contours. The patient underwent a total right nephrectomy. The nephrectomy specimen received for pathological examination showed macroscopically an encapsulated cystic mass of 4 cm long axis. The cyst lumen was occupied by solid brownish tissue debris. Histologically, the cystic wall was lined by a keratinizing squamous epithelium with accumulation of keratin lamellae in the cystic lumen. Anatomopathological examination concluded to the diagnosis of renal epidermoid cyst.

A Case Report of Calyceal Diverticulum: Differential Diagnosis for Organ-Preserving Operations

Calyceal diverticula and epidermal cysts are extremely rare kidney lesions with unknown etiology and pathogenesis. They have non-specific clinical and radiological picture. Despite the benign nature, sometimes these disorders mimic malignant tumors leading to unjustified nephrectomy. We present a clinical and morphological observation of a multicystic lesion in a 76-year-old patient's right kidney filled with keratinized masses and imitating a malignant solid tumor. The detailed gross, histological and immunohistochemical (desmin, cytokeratin 7, uroplakin and p63) analyses of the kidney tissue excluded the malignant nature of the lesion. The final differential diagnosis was between an epidermal cyst and calyceal diverticulum with pronounced squamous cell metaplasia of urothelium. The upper pole localization of the lesion, its connection with the pelvicalyceal system through the unobstructed isthmus, the presence of urothelial lining and smooth muscle cells in its wall let us diagnose a calyceal diverticulum type I. Knowledge of the key clinical and morphological features of epidermal cysts and diverticula of the pelvicalyceal system will help the practicing physicians suspect the benign nature of such lesions and perform organ-preserving operations.

A rare case of epidermoid cyst in urinary bladder

Epidermoid cyst in urinary bladder is a rare pathology with only one known case published prior to this study. In this article, we described imaging findings of epidermoid cyst in the urinary bladder and other parts of urogenital system. Plain CT KUB was performed on Multidetector 16 slice computed tomography scanner-GE Bright speed Elite and plain magnetic resonance imaging on 1.5 T Siemens Magnetom Avanto.

Giant pelvic retroperitoneal epidermoid cyst: a rare case report

Epidermoid cyst is a frequent benign cutaneous tumor. The pelvic localization does not occur very often. The literature that taps into such cases is very limited in scope. Here is a report of a 27-year-old woman with a giant pelvic retroperitoneal epidermoid cyst. The use of ultrasound exploration and computed tomography has indicated ovarian origins. The surgery also revealed a retroperitoneal epidermoid cyst, uterus and ovaries were all intact. The evacuation of a cyst was found to contain lamellas of keratin. Histology permitted us to confirm the diagnosis. The patient was faring well after two years of followup.