Outcome and follow-up:
On follow-up, the patient developed resistant urinary tract infection
two-weeks after discharge, for which she was hospitalized and treated
with intravenous meropenem. She also received daily nitrofurantoin as
maintenance therapy for several months and continued to be followed by
an oncologist with interval imaging. At three months post-surgery, renal
sonography showed a simple cyst with a diameter of 19 mm and an
echogenic mass lesion measuring 20*28 mm in the lower bridge and sinus
of the right kidney (respectively) as well as mild hydronephrosis.
Moreover, lab tests demonstrated normocytic anemia, elevated creatinine,
and hematuria. Three months after the operation, at the oncologist’s
discretion, an FDG PET/CT scan (Discovery 690 VCT 64 Slicer, General
Electric, USA) was performed for the patient that showed a
hypermetabolic mass in the right kidney involving the pelvicalyceal
system (SUVmax: 13.3) and the cortex
(SUVmax: 6.3). Normal FDG activity was seen in the axial
skeleton (Figure 3). As to the time of writing this report, the patient
is alive and in good general condition. She is being monitored with
imaging and is receiving oral prednisolone (5 mg/ twice daily), as
prescribed by her oncologist. The right renal mass lesion has gradually
decreased in size on follow-up imaging studies.