CASE HISTORY

Six months before admission patient noticed a swelling in her abdomen. It did not trouble her and she took no notice of it. Three months later she became pregnant and subsequently attended the antenatal clinic where this abdominal mass was found and she was referred to the Surgical Department. On admission: she was a healthy woman with no complaints or physical signs apart from the lump. This lay in the upper left quadrant of the abdomen and extended from above the costal margin across to the mid line and down to the iliac crest. There was a band of resonance over it but no notch could be felt. The possibility of splenomegaly was considered and blood investigations were done but were all negative. Finally pyelography showed displacement of the left kidney and deformity of its pelvis. A laparotomy was performed and this tumour was found attached to the lateral-border of the kidney from which it could be dissected free. The patient made a good recovery and her pregnancy went to term.

PATHOLOGY

Kidney 255mmx275mmx100mm. This specimen represents a half of the tumour.  It is a multilocular, fibrous walled cyst.  The loculi were all filled with a serous, protein-containing fluid which coagulated on fixation in formalin.  The loculi vary in size but most of them are small.  On the back of the specimen the site of attachment to the kidney can be seen.