Case 75: An Elderly Male with an Incidentally Found Renal Tumor

Tiffany Sheganoski, DO Arash Lahouti, MD

Clinical History

An elderly male with polycystic kidney disease (PCKD) status post living donor kidney transplant and recurrent Gram negative bacteremia. He underwent nephrectomies of his bilateral native kidneys.

Past Medical History

The patient’s past medical history included hypertension, hyperlipidemia, atrial fibrillation, and gout. He underwent kidney transplant in 2001 for his PCKD and was on maintenance immunosuppressive therapy.

Recent History

The patient experienced recurrent Gram-negative bacteremia. CT showed numerous cysts within the native kidneys. Initially, the source of bacteremia was thought to be the gallbladder. However, he still experienced bacteremic episodes post-cholecystectomy. Then, he underwent bilateral nephrectomy due to clinical suspicion of kidneys as a source of recurrent bacteremia.

Gross examination of the nephrectomy specimens revealed that the parenchyma of the bilateral kidneys was entirely replaced by innumerable thin-walled cysts. One of the cysts within the right kidney had a calcified and slightly thickened wall.

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