# Diagnostic challenges in infected cystic papillary renal cell carcinoma following recent right limited hemicolectomy

## TL;DR

A patient with a previously diagnosed kidney cyst faced a difficult diagnosis between infection and cancer after recent surgery, leading to a cancer diagnosis.

## Contribution

Highlights the diagnostic challenge and management of infected Bosniak IIF cysts with potential malignancy.

## Key findings

- The cyst showed features consistent with both abscess and infected renal cell cancer.
- Histopathology confirmed papillary renal cell carcinoma after partial nephrectomy.
- Bosniak IIF cysts carry a significant risk of malignancy despite routine follow-up.

## Abstract

In this case we present a diagnostic challenge of a renal cyst that has radiological features that were hard to differentiate between infection and malignancy. Our patient presented with suspicious infected right renal cystic lesion, 4 months after undergoing complicated appendectomy with limited right hemicolectomy. This cyst was diagnosed previously as Bosniak IIF and was assigned for follow up every 6 months. Radiological assessment was in favor of abscess formation however it was also concerning for infected renal cell cancer. As only drainage may cause seeding of potential cancer cells, right partial nephrectomy was done. Histopathology was papillary cancer. Bosniak IIF cystic lesions are still managed with follow up, however this type of cystic lesions carries considerable risk of malignancy according to most recent studies; we are presenting this case report to emphasis this fact and to highlight the importance of proper diagnosis and treatment choice.