Giant Bosniak I left simple renal cyst with symptomatic compression in an elderly patient: case report

Abstract

Introduction: We present a novel case of a 71-year-old male patient with a simple renal cyst of Bosniak I classification, which evolved with significant growth and compressive symptoms, and required surgical management. Case presentation: 71-year-old male patient diagnosed in 2018 with left simple renal cyst, comes to urology consultation for presenting lumbar and abdominal pain in left flank. Physical examination revealed pain on deep palpation in the left flank radiating to the dorsal region, a slight degree of distention and palpation of a relatively soft, regular mass in the left upper hemiabdomen. A computed tomography urogram was performed without administering intravenous contrast with cross-sectional tomographic sections and curved multiplanar reconstructions following the renal excretory systems, observing lobulated kidneys, parenchymal thickness up to 1.3 cm. In the left kidney there is an encapsulated peripheral cystic formation measuring in the sagittal plane 10.7 x 9 cm, with micro calculi, no hydronephrosis is seen, maintaining the Bosniak I classification. The kidney measures 11.4 x 5.2 cm in the sagittal plane. The right kidney in the sagittal plane measures 9.8 x 5.2 cm with a small peripheral cyst of 2 cm and moderate dilatation of the renal pelvis. Conclusions: It is uncommon for a simple renal cyst to have significant growth, thus generating symptomatology due to compression of adjacent structures.