Nefroma quístico en la infancia / Cystic nephroma in childhood

Nefroma quístico (NQ) es una lesión quística multilocular neoplásica del riñón que cae en un espectro de enfermedades. Existe cierto debate acerca de si estas lesiones representan un espectro de una enfermedad con una etiología común. Un quiste multilocular no es un segmento renal afectado por la enfermedad renal multiquística ya que estas condiciones difieren clínica, histológica y radiográficamente. Sin embargo, la controversia continua sobre si el quiste multilocular es una forma de displasia renal segmentaria. El nefroma quístico es una lesión renal característica con un comportamiento bimodal y un curso clínico benigno. Presenta un peak de distribución en los primeros 2 a 3 años, sobretodo en hombres y otro peak en la 4ª y 5ª década de la vida con un aumento significativo de su prevalencia en mujeres. El diagnóstico pre-operatorio preciso para diferenciar el NQ de otras entidades quísticas renales malignas puede ser imposible sólo con el examen clínico y radiológico; es la histopatología la que provee el diagnóstico final. Se hace una revisión del NQ con especial interés en la afectación en los pacientes pediátricos.

Cystic nephroma (NQ) is a multilocular cystic neoplasm of the kidney that falls on a spectrum of diseases. There is some debate about whether these lesions represent a spectrum of disease with a common etiology. A cyst is not multilocular renal segment affected by multicystic kidney disease because these conditions differ clinically, histologically and radiographically. However, the controversy continue over whether the multilocular cyst is a form of segmental renal dysplasia. Cystic nephroma is a renal lesion with characteristic bimodal behavior and a benign clinical course. Distribution presents a peak in the first 2 to 3 years, especially in men and another peak in the 4 th and 5 th decade of life with a significant increase in its prevalence in women. The accurate preoperative diagnosis to differentiate NQ from other malignant cystic kidney entities may not be possible only with the clinical and radiological examination, histopathology is that provided the final diagnosis. A review of NQ with emphasis on involvement in pediatric patients it is made.

Alcoolização percutânea de cistos renais: revisão da literatura e apresentação de resultados / Percutaneous ethanol sclerotherapy of renal cysts: treatment outcomes and literature review

OBJETIVO: Demonstrar a eficácia e os resultados práticos da alcoolização percutânea de pacientes com cistos renais simples sintomáticos. MATERIAIS E MÉTODOS: Foram revistos os resultados obtidos em dez pacientes com cistos renais simples sintomáticos (oito homens e duas mulheres), com idade entre 28 e 72 anos (média de 55 anos), submetidos a pelo menos duas alcoolizações percutâneas. A indicação do procedimento foi dor no flanco refratária nos dez pacientes, sete deles com algum grau de hidronefrose pela localização parapiélica do cisto. O volume aspirado variou entre 20 e 1.300 ml (média de 200 ml). O tempo médio de seguimento após o procedimento foi de sete meses. O procedimento foi dirigido por ultrassonografia em dois casos e por tomografia computadorizada em oito. O tempo de internação variou entre 24 e 72 horas. Foi considerado sucesso completo do tratamento o desaparecimento do cisto, e parcial a redução maior que 50 por cento. RESULTADOS: Durante o seguimento houve redução completa do cisto em sete pacientes e redução parcial em três. Em nenhum caso foram registradas complicações e os pacientes toleraram bem o procedimento. CONCLUSÃO: A alcoolização percutânea de cistos renais sintomáticos é um procedimento seguro, efetivo e pouco invasivo e com resultados semelhantes aos obtidos por outros autores.

OBJECTIVE: To demonstrate the effectiveness and practical outcomes of percutaneous ethanol sclerotherapy in patients with symptomatic simple renal cysts. MATERIALS AND METHODS: The authors reviewed the outcomes of ten patients (eight men and two women) in the age range between 28 and 72 years (mean, 55 years) submitted to at least two procedures of percutaneous sclerotherapy for symptomatic simple renal cysts. Main presentation was refractory flank pain in all patients, seven of them with some degree of hydronephrosis because of the parapyelic localization of the cyst. The aspirated volume ranged from 20 to 1300 ml (mean, 200 ml). The mean follow-up period following the procedure was of seven months. Two patients had ultrasoud-guided sclerotherapy, and eight, computed tomography-guided sclerotherapy. The hospital stay period ranged between 24 and 72 hours. Complete success corresponded to total cyst regression, and partial success corresponded to recurrence of less than half the original cyst volume. RESULTS: Complete cyst ablation was achieved in seven patients and partial resolution in three. No complication was observed and the therapy was well tolerated by all of the patients. CONCLUSION: Percutaneous ethanol sclerotherapy of symptomatic simple renal cysts is a safe, effective and minimally invasive procedure, with results similar to the ones reported by other studies.

Quiste renal infectado: caso clínico y revisión de la literatura / Renal cyst infected: case report and revision

We describe a case of a 29 years old woman with an infected simple renal cyst in which no etiologic agent was found. The diagnose was made by cystic fluid aspiration. Antibiotic therapy by itself was not enough to control the infection and a percutaneous drainage was performed with rapidly normalization of the inflammatory parameters. The case is presented and a literature review on simple renal cyst is made.

Quiste multilocular del riñón: presentación de un caso / Multilocular renal cyst: a case report

Presentamos un nuevo caso de quiste multilocular del riñón en el adulto. Esta entidad es sumamente rara y se plantean varias hipótesis sobre su origen. El riñón no tiene configuración reniforme: típicamente el riñón tiene la apariencia de un racimo de uvas, sin estroma entre los quistes. El tamaño renal es muy variable, pero en ocasiones llega a ser una gran masa que ocupa la mayor parte del abdomen. Se plantea que la diferencia entre esta entidad benigna y los tumores renales intraquíticos solo se puede establecer mediante estudios minuciosos de la pieza anatómica. Se revisa la literatura encontrada sobre el tema y se comenta la problemática en torno al diagnóstico y a las posibilidades terapéuticas(AU)

We present a new case of cyst multilocular of the kidney in the adult. This entity is extremely strange and they think about several hypothesis on its origin. The kidney doesn't have configuration reniforme: typically the kidney has the appearance of a cluster of grapes, without estroma among the cysts. The renal size is very variable, but in occasions it ends up being a great mass that occupies most of the abdomen. He/she thinks about that the difference between this benign entity and the tumors renal alone intraquíticos can settle down by means of meticulous studies of the anatomical piece. The opposing literature is revised on the topic and the problem is commented around the diagnosis and to the therapeutic possibilities(AU)