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Congenital Giant Simple Symptomatic Renal Cyst in a Child - Rare Pathology - Ultrasonography and CT Evaluation - A Case Report

Simple renal cyst (SRC) is uncommon paediatric pathology. It's spherical, round to oval. Perceptible wall, anechoic, without septa, and cyst is separated from the collecting system, and the cyst has no colour Doppler flow. They may be as small as a pea or as large as a golf ball. Simple renal cysts are filled with serous fluid and have a simple epithelial covering. They are less common in children with incidences of less than 0.5 percent, while adults have incidence of more than 10 %, and more than 30 % in adults aged 70 and older. The exact mechanism by which renal cysts form is unknown. There are a few theories of how the disease develops. The causative factor, according to one hypothesis, is a focal ischemia in a renal tubule that causes localised obstruction. According to another hypothesis, renal cysts are caused by calyceal diverticula that have lost contact with the adjacent calyx.1 Because of the increased use of ultrasound screening (USS), more children are being diagnosed with renal cysts. Asymptomatic and symptomatic cysts (abdominal pain, hematuria, etc.) are distinguished, but mostly asymptomatic cysts develop slowly, though complications such as bleeding, infection, or rupture may occur, particularly in younger children.2 Chronic kidney disease (CKD), polycystic kidney disease, malignant transformation, and symptomatic enlargement have all been identified in paediatric patients with renal cysts. The vast majority of renal cysts, fortunately, do not develop and remain largely unchanged over time. In cases of asymptomatic simple renal cysts in infants, a conservative management approach is used. Recent research supports the use of an ultrasound-based (US) adapted Bosniak classification system to classify renal cysts in children. This would result in lower rates of surgical treatments for benign lesions, as well as less ionising radiation from needless computed tomography (CT) scans. It would also mean less extended monitoring and associated morbidity.