Massive renal adenomatosis: a case exhibiting low-grade malignancy

Area of Science:

• Nephrology
• Oncology
• Pathology

Background:

• Polycystic kidney disease (PKD) is a genetic disorder characterized by numerous cysts in the kidneys.
• Differential diagnosis of enlarged kidneys includes cystic diseases and neoplastic processes.
• Rare presentations of renal pathology can mimic common conditions.

Observation:

• Autopsy of a young male patient revealed massive bilateral renal enlargement.
• Radiographic findings initially suggested polycystic kidney disease.
• The enlargement was attributed to innumerable, multifocal tumors of atypical renal tubular epithelium.

Findings:

• Microscopic examination showed neoplasms ranging from renal adenoma to low-grade renal cell carcinoma.
• Electron microscopy confirmed the epithelial origin of these renal tumors.
• Metastases were identified in local lymph nodes and as pulmonary micrometastases.

Implications:

• This case highlights a rare entity that can be mistaken for polycystic kidney disease.
• Understanding such atypical presentations is crucial for accurate diagnosis and management.
• The findings contribute to the literature on rare renal neoplasms and their clinical outcomes.