Page 18 - Journal of Special Operations Medicine - Winter 2016

Table 1 Additional Laboratory Tests Figure 1 CT scan of the chest, abdomen, and pelvis revealing
normal lungs, liver, spleen, and right kidney but marked
Reference
Test Result Range cystic replacement of the left kidney.
White blood cell count, 6.9 × 10 3 4.0–10.0 × 10 3
per μL
Red blood cell count, per μL 6.94 × 10 6 4.4–5.7 × 10 6
Platelet count 160,000 130–400,000
Hemoglobin, g/dL 22.0 14.0–17.4
Hematocrit, % 64 42–52
Mean corpuscular volume, fL 87.9 80–100
Red cell distribution width, % 13.5 11.5–14.5
Hemoglobin A, % 97.6 95–95
Hemoglobin F, % 0.0 0–2
Hemoglobin A2, % 2.4 2–3
Erythropoietin, mIU/L 10.5 0–19
Carboxyhemoglobin, % 4 0–3
ESR, mm/h 0 <15
Serum creatinine, mg/dL 0.80 0.6–1.3 Figure 2 Pathologic evaluation of the left nephrectomy
BUN, mg/dL 15 10–26 revealed a 22cm cystic mass, completely replacing the kidney
Glucose, mg/dL 89 70–115 parenchyma.
Calcium, mg/dL 9.7 8.5–10.5
Uric acid, mg/dL 5.9 3.0–7.4
Albumin, g/dL 4.2 3.5–5.5
Total protein, g/dL 7.5 6.0–8.0
Aspartate aminotransferase, 27 7–40
U/L
Alanine aminotransferase, U/L 39 0–40
Alkaline phosphatase, U/L 72 38–126
Bilirubin (total), mg/dL 1.20 0.2–1.0
TSH, mIU/L 1.28 <10
BUN, blood urea nitrogen; ESR, erythrocyte sedimentation rate; TSH,
thyroid-stimulating hormone.

headaches, hypertension, hematuria, and erythrocytosis
were resolved. different sizes and normal or atrophic surrounding pa-
renchyma. There is a noteworthy absence of a family
history of disease, disease progression, renal impair-
Discussion
ment, encapsulated mass, or multiorgan involvement.
A literature search revealed that there are fewer than The presence of a few simple cysts in the contralateral
70 reported cases of unilateral renal cystic disease kidney does not exclude the diagnosis of URCD. 2,7,9
(URCD). Early reports described cases as unilateral
1–3
5
4
polycystic renal disease, segmental polycystic disease, It is unclear what leads to the development of URCD.
and unilateral, localized cystic disease of the kidney. Due to the resemblance of URCD to autosomal domi-
6
The most accepted names today are URCD or localized nant polycystic kidney disease (ADPKD), it was pro-
7
(segmental) cystic disease of the kidney (LSCDK). In posed that URCD may develop secondarily to a somatic
10
2005, a review documented 54 cases of URCD, includ- mutation in the PKD1 gene. There appears to be a
7
ing a robust publication of 18 cases. 8 male predilection and diagnosis is often made in adult-
hood. The presenting symptoms range from no symp-
8
URCD may be recognized through a constellation of toms to flank pain, hematuria, or abdominal mass.
7
features that include multiple unilateral renal cyts of Diagnosis is often made with CT or magnetic resonance
2 Journal of Special Operations Medicine Volume 16, Edition 4/Winter 2016