[Multilocular cyst of the kidney: diagnostic problems. Apropos of a case in an adult]

The authors report a case of multilocular cyst of the kidney in an adult. The diagnosis was made, despite the fact that hydatid disease was endemic in the area, on the basis of the finding at urography of a renal mass with the density of water, the finding at echotomography of a multiloculated mass of mixed nature and finally the absence of any blood supply at arteriography. Excision of the multilocular mass left in place a normal kidney with a good result confirmed after 18 months' follow-up. This case is used as a basis to describe the differential diagnosis in the context of the results of special investigations: I.V.U., echotomography, CT scan and arteriography. Diagnoses which must be eliminated are: renal adenocarcinoma in its necrosed form, solitary renal cyst, angiomyolipoma, nephroblastoma and, in endemic areas obviously, hydatid cyst, in particular in its multivesicular form. Despite the multiplicity of investigations, the diagnosis is often uncertain until the time of surgery. Treatment is excision of the abnormal mass with preservation of healthy parenchyma.