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Segmental multicystic dysplastic kidney in children: clinical presentation, imaging finding, management, and outcome
Chun-Chen Lin1, Jeng-Daw Tsai, Jin-Cherng Sheu
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
Insights
Segmental multicystic dysplastic kidney (MCDK) in children often occurs in duplex systems and typically resolves spontaneously. Associated urinary tract anomalies may require intervention, but segmental MCDK itself rarely needs surgical removal.
Area of Science:
- Pediatric Urology
- Renal Pathology
- Medical Imaging
Background:
- Multicystic dysplastic kidney (MCDK) is a congenital anomaly.
- Segmental MCDK is a specific subtype affecting a portion of the kidney.
Purpose of the Study:
- To evaluate the clinical presentation, imaging characteristics, treatment, and outcomes of segmental MCDK in pediatric patients.
- To understand the natural history and management strategies for this condition.
Main Methods:
- Retrospective review of medical records for six pediatric patients diagnosed with segmental MCDK.
- Data collection included initial symptoms, imaging results, associated anomalies, surgical interventions, and patient outcomes.
Main Results:
- Three patients were diagnosed prenatally via ultrasound, remaining asymptomatic postnatally.
- The other three presented with symptoms like a renal mass, urinary tract infections, or incontinence.
- Five patients had associated urinary tract abnormalities; spontaneous cyst involution occurred in all over a mean of 40 months.
Conclusions:
- Segmental MCDK commonly affects the upper pole of duplex kidneys and frequently involutes spontaneously.
- Clinical presentation and outcomes are influenced by associated anomalies, which may necessitate surgical correction.
- Segmental MCDK itself rarely requires surgical resection.
Purpose:
The aim of the study was to assess the presentation, imaging findings, management, and outcome of segmental multicystic dysplastic kidney (MCDK) in children.
Materials And Methods:
Six patients with segmental MCDK were diagnosed and observed at our hospital. We reviewed the medical records to collect data on initial symptoms, results of imaging studies, associated urinary tract anomalies, operation, and outcome.
Results:
Three patients had abnormal prenatal ultrasound and were diagnosed by further postnatal imaging; they were asymptomatic after birth. The other 3 children presented with a renal mass, recurrent urinary tract infection, or urinary incontinence. Five patients had associated ipsilateral or contralateral urinary tract abnormalities, including vesicoureteral reflux, ureterocele, duplex collecting system, ureteropelvic junction stenosis, and ectopic ureter. Lower tract reconstruction was performed in 3, and open biopsy was done in 1 child. None underwent partial or total nephrectomy, and all had involution of the cysts for a mean of 40 months.
Conclusions:
Most of the cases occur in the upper pole of a duplex kidney and often involute spontaneously without significant complication. The clinical presentation and imaging findings depend on the associated anomalies and complications. Although the latter may require surgery to resolve, segmental MCDK itself rarely requires resection.
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