PMC8585544_01
Abdominal examination shows a distended abdomen with cystic appearance on palpation. The marking site is left flank.
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fig1
The swelling became prominent since one year (Figure 1), with associated dull aching left flank pain.
Noncontrast CT scan of the abdomen shows (a) axial view, (b) coronal view, and (c) sagittal view. It shows 20 cm long, 16 cm width cystic swelling (red arrow) with significant mass effect to the surrounding bowel loop (blue arrow).
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fig2
The dilatation spans seven vertebral lengths with the inferior border reaching the pelvis (Figure 2).
Resected sac (white arrow) with a narrowed left ureter and ureteropelvic junction (red arrow).
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fig3
The left ureter was explored and showed severe stenosis at the level of ureteropelvic junction (Figure 3).
Histopathologic section shows an unremarkable ureteral wall with no increased wall thickness, fibrosis, or inflammation.
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fig4
Histopathologic examination of the biopsy showed a hydronephrotic kidney with no feature of malignant growth (Figure 4).