Laparoscopic Deroofing and Excision of a Large Left Renal Cyst Mimicking Chest Infection: Case Report

Background: The routine use of abdominal ultrasonography and computed tomography scan has increased the detection of asymptomatic renal cysts. Laparoscopy is usually suitable for treating large symptomatic renal cysts. Objective: To report a case of laparoscopic treatment of a man with large left renal cyst mimicking chest infection. Case presentation: A 75-year-old man, known hypertensive who had empirical treatment for chest infection without resolution of symptoms of cough and chest pain. He was on treatment for storage and voiding lower urinary tract symptoms with 10mg alfuzocin. Abdominal ultrasound and computed tomography scan confirmed a large left renal cortical cyst that measured 380mls. He subsequently had transperitoneal laparoscopic deroofing and excision of the renal cyst with operation finding of 300mls of straw coloured fluid excluding spillage. The immediate postoperative period was uneventful, and he was discharged home in a stable condition on the second day. The aspirate yielded no growth while the cytology report of cystic fluid was acute-on-chronic inflammation. Histology was reported as chronic pyelonephritis with cystic degeneration. Conclusion: Large renal cyst should be considered as differential diagnosis of unresolved chest infection and is safely treated by laparoscopic deroofing and excision.