[Renal pelvic tumor associated with contralateral renal cyst--a case report]

A 74-year-old female presented with a two years history of malaise, weakness and intermittent gross hematuria. Two years earlier, left renal cyst had been diagnosed by excretory urography, abdominal sonography and computed-tomography. Initially she was treated conservatively with oral antibiotics, however medical management had not been successful in improving her condition. Finally she was transfer to our ward for further evaluation and treatment. Cystoscopic examination demonstrated no abnormality, except for bloody urine efflux from the right ureteric orifice. Right retrograde pyelograms confirmed a solitary filling defect in the upper calyx of right kidney. Because of immediate concern for right renal pelvic tumor and contralateral renal cyst, a midline transperitoneal exploration was made. The right nephroureterectomy with cuff of bladder was removed and left unroofing of cyst was carried out. Convalescence was uneventful. The pathologic examination revealed moderately differentiated transitional cell carcinoma of right kidney with a simple renal cyst of left kidney. We suggest that cases with a clinical diagnosis of renal cyst based on the presence of gross hematuria, a normals excretory urogram and computed tomogram, generally require further evaluation especially by cystoscope and retrograde pyelogram to determine the source of bleeding.