A case of medullary sponge kidney (Cacchi-Ricci disease) mimicking a renal mass
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Updated: Aug 13, 2026
In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
Published on: March 30, 2015
Giovanni Fellegara1, Elisabetta Froio, Tu-Vinh Luong
1Department of Pathology and Medicine of Laboratory, Section of Pathological Anatomy and Histology, University of Parma, Italy.
Abstract:
Medullary sponge kidney (MSK) is an uncommon benign congenital disorder, generally asymptomatic. In symptomatic patients the diagnosis is usually made by excretory urography performed in the most frequent complications such as renal stones, urinary tract infections and haematuria. Excretory urography can be very characteristic, showing cystic collections of ectatic collecting ducts like "bunches of grapes" or "bouquet of flowers". When haematuria represents the only symptom, and radiographic findings are not characteristic of MSK, the differential diagnosis with a renal tumor can be very difficult. We report a case of MSK that underwent nephrectomy since clinical and radiological features mimicked a renal tumor.
Insights
Medullary sponge kidney (MSK) is a rare congenital kidney disorder. Misdiagnosis can lead to unnecessary surgery, highlighting the importance of accurate imaging for symptomatic cases.
Area of Science:
- Nephrology
- Medical Imaging
- Congenital Disorders
Background:
- Medullary sponge kidney (MSK) is a rare, benign congenital kidney disorder.
- Diagnosis is typically via excretory urography, revealing characteristic cystic collections in ectatic collecting ducts.
- Common complications include renal stones, UTIs, and hematuria.
Observation:
- A case of MSK presented with hematuria as the sole symptom.
- Radiographic findings were atypical, closely mimicking a renal tumor.
- The patient underwent nephrectomy due to the diagnostic uncertainty.
Findings:
- The case highlights the diagnostic challenge when hematuria is the only symptom of MSK.
- Atypical radiographic presentations can lead to misdiagnosis and inappropriate surgical intervention.
- Accurate interpretation of imaging is crucial for differentiating MSK from renal tumors.
Implications:
- This case underscores the need for careful differential diagnosis in suspected MSK.
- Improved imaging interpretation protocols may prevent unnecessary surgeries for MSK patients.
- Enhanced awareness of MSK's varied presentations is vital for clinical practice.
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