Sandbox: DDx Kidney mass

• Infants and children
• Abdominal discomfort, polyuria, polydipsia, and hypertension
• Oligohydramnios, respiratory distress, and Potter sequence
• ESRD, intracranial hemorrhage, congenital hepatic fibrosis

• Bilateral cystic abdominal mass
• Marked abdominal distention

• Elevated serum creatinine and BUN levels
• Serum albumin level < 3.5 g/dL
• Microhematuria
• Elevated maternal alpha fetoprotein

• Enlarged echogenic kidneys
• Multiple bilateral microcysts, size <2cm
• Poor corticomedullary differentiation

• Elongated cysts arranged in a radial pattern
• Cystic spaces, lined by cuboidal cells, and surrounded by interstitial fibrosis

• PKHD1 gene mutation
• Chromosome 6p

Nonmalignant causes

acquired cystic kidney disease autosomal dominant polycystic kidney disease autosomal recessive polycystic kidney disease cystic renal dysplasia glomerulocystic kidney medullary sponge kidney mesothelial cysts nephronophthisis simple cysts