Cystic Renal Anomalies (Differential Diagnosis UTI/Abdominal Tumor)

harn_27a_n.jpg and harn_27b_n.jpg: Preparations from a 4-year-old girl with recurrent UTI. harn_27a_n.jpg: Polycystic structure of 6 cm in length; neither a renal pelvis nor a ureter is recognizable with certainty. harn_27b_n.jpg: Piece of ureter of 6 cm in length. The ureter catheter introduced from the bladder has perforated its upper end. harn_27a_n.jpg and harn_27b_n.jpg: The diagnosis is multicystic kidney (aplastic cystic kidney) with distal ureter without connection to the corresponding kidney. Multicystic kidneys may be the cause of repeated UTI due to combined malformations; in this case due to an anomaly of the orifice and reflux in the residual ureter. A reflux or another malformation of the contralateral side is also possible. In multicystic kidney there is a controversy concerning the treatment. A large and space-occupying abdominal tumor due to a multicystic kidney in the neonate should be resected initially or in case of persistence. Notice the size of the mass in spite of the age of this patient. In any case combined malformations should be recognized and if necessary operated because these patients have only one functioning kidney.