Laparoscopic management in a rare case of bilateral perirenal lymphangiomatosis

Refractory lymphatic ascites following laparoscopic management of renal lymphangiectasia: An unusual presentation

Renal lymphangiectasia characterised by either unilocular or multilocular cystic lesion in and around the kidney is an uncommon condition. Presentation of these lesions is quite varied, which along with its uncommon occurrence adds to the challenges in the management of this condition. Most of these cases are managed conservatively and very rarely need any intervention. We present an unusual complication of refractory lymphatic ascites following laparoscopic deroofing of a unilocular renal lymphangiectasia in a 21-year-old gentleman who presented with left flank pain. The ascitic fluid analysis suggested non-chylous lymphatic ascites. The surgical outcome was rather exasperating for the patient than the disease itself. Hence, in the interest of the patient with minimal symptoms, if the imaging is highly suggestive of renal lymphangiectasia, either no intervention or the least invasive procedures should be attempted, whenever possible.

Triparametric ultrasound in differentiating multicystic renal masses: a rare presentation of unilateral focal renal lymphangioma

We describe a rare case of renal lymphangioma presenting as a focal unilateral multicystic renal mass and document the first reported use of triparametric ultrasound (B-mode, Doppler, and contrast-enhanced ultrasound) in its diagnosis and discrimination from other focal multicystic lesions. Renal lymphangiomas are rare, benign, typically developmental lesions composed of cystic dilatation of the lymphatic ducts, usually occurring bilaterally as perinephric collections or parapelvic cysts mimicking hydronephrosis. Radiologists have an important role in suggesting the diagnosis, as clinical presentation can be nonspecific. Management is usually conservative; however, nephron-sparing surgery may be recommended in symptomatic individuals.

Isolated Renal Sinus Lymphangiectasia-Close Mimic of Pelviureteric Junction Obstruction and Hydronephrosis

Renal lymphangiectasia is a rare disorder which may present as perirenal or peripelvic collection. Isolated renal sinus lymphangiectasia is a close differential diagnosis for pelviureteric junction obstruction on ultrasound, but can be resolved without ambiguity using computed tomography and magnetic resonance imaging. Here we describe such a case where imaging helped avoid unnecessary confusion.