A 53-year-old female with a history of urolithiasis, smoking and estrogen use underwent noncontrast computerized tomography (CT) of the abdomen to evaluate for the presence of renal or ureteral calculi. A cystic lesion was noted in the left kidney. A subsequent triphasic CT of the abdomen revealed a 5.1 X 5.5 cm cystic mass with numerous thick enhancing internal septations and a central enhancing nodule (fig. 1). The mass was located in the upper pole of the left kidney, and a small portion of the mass herniated into the renal pelvis and splayed the upper pole collecting system (fig. 2). No calcifications were present in the mass and there was no vascular involvement. Based on these features, the mass was categorized as a Bosniak IV cystic lesion, which has a high likelihood of being cystic renal cell carcinoma. Partial left nephrectomy was performed and final pathological diagnosis was mixed epithelial and stromal tumor of the kidney (MEST). Followup imaging for 2 years revealed no recurrent disease.
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机译：一名53岁女性，有尿路结石，吸烟和使用雌激素的病史，对他们的腹部进行了非对比计算机断层扫描（CT），以评估是否存在肾结石或输尿管结石。在左肾中发现囊性病变。随后腹部的腹部CT表现为5.1 X 5.5 cm囊性肿块，内部有许多浓密的强化分隔和一个中央强化结节（图1）。肿块位于左肾的上极，一小部分肿块突入肾盂并扩张了上极收集系统（图2）。肿块中没有钙化，也没有血管受累。基于这些特征，肿块被归类为Bosniak IV囊性病变，极有可能是囊性肾细胞癌。进行部分左肾切除术，最终病理诊断为肾脏上皮和基质间质混合瘤（MEST）。随访2年未发现复发。
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