Hidronefroz ile Karışan Böbreğin Müsinöz Adenokarsinomu: Nadir Bir Olgu Sunumu

Abstract

Böbreğin müsinöz adenokarsinomu, sıklıkla renal pelvisten köken alan, oldukça nadir görülen bir malignitedir. Kistik görünümü nedeniyle genellikle hidronefroz veya renal kist gibi benign durumları taklit eder ve bu durum preoperatif tanıyı güçleştirir. Yirmi yıldır bilateral tekrarlayan nefrolityazis öyküsü bulunan 57 yaşındaki erkek hasta, sol üst abdominal bölgede distansiyon ve dispeptik şikayetlerle başvurdu. Görüntülemelerde, korteksi incelmiş ve çok sayıda taş içeren, ciddi hidronefrotik, fonksiyon göstermeyen sol böbrek saptandı. Perkütan nefrostomi yerleştirildi; ancak mükopürülan materyalin etkin drenajı sağlanamadı. Böbrek fonksiyonunun zayıf olması ve devam eden drenaj nedeniyle sol nefrektomi gerçekleştirildi. Histopatolojik inceleme, müsin üreten atipik kolumnar epitel hücrelerini göstererek müsinöz adenokarsinom ile uyumlu bulundu. Böbreğin müsinöz adenokarsinomu, yalnızca görüntüleme yöntemleriyle hidronefroz veya renal kistlerden ayırt edilmesi zor bir tümördür. Erken şüphelenme ve cerrahi tedavi, uygun yaklaşım ve olumlu sonuçlar açısından hayati öneme sahiptir.

Keywords

• Müsinöz adenokarsinom
• böbrek
• hidronefroz
• kist

Mucinous Adenocarcinoma of the Kidney Mimicking Hydronephrosis: A Rare Case Report

Abstract

Mucinous adenocarcinoma of the kidney is a very rare malignancy, frequently originating from the renal pelvis. Its cystic appearance often resembles benign conditions such as hydronephrosis or renal cysts, complicating preoperative diagnosis. We present a 57-year-old male with a 20-year history of recurrent bilateral nephrolithiasis with left upper abdominal distension, vague discomfort, and dyspeptic symptoms. Imaging revealed a severely hydronephrotic, non-functioning left kidney with cortical thinning and multiple calculi. A percutaneous nephrostomy was attempted but failed to provide effective drainage of the mucopurulent material. Due to poor renal function and persistent drainage, a left nephrectomy was performed. Histopathology demonstrated mucin-producing atypical columnar epithelium, consistent with mucinous adenocarcinoma. Mucinous adenocarcinoma of the kidney is difficult to differentiate from hydronephrosis or renal cysts based solely on imaging. Early suspicion and surgical management are essential for appropriate treatment and favorable outcomes.

Keywords

• Mucinous adenocarcinoma
• kidney
• hydronephrosis
• cyst

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