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Answer: E. All of the above.

Below are additional images from subsequent MRI evaluation:

Image 2: Axial MRI

Image 3: T2-weighted images and gadolinium-enhanced fat-suppressed gradient echo image.

Image 4: Again demonstrates the cystic left upper quadrant mass.

The origin of the mass is from the left kidney (arrow in Image 3). The cystic mass contains multiple high signal daughter cysts on T2-weighted images. Only the wall of the parent cyst (arrow in Image 4) enhances following contrast administration.

Question: The differential diagnosis for a cystic renal mass includes all of the following EXCEPT?

  • Renal abscess
  • Cystic renal cell carcinoma
  • Echinococcal cyst
  • Renal lymphoma
  • Multilocular cystic nephroma

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We welcome your feedback, please send questions and comments to Marcel Maya, MD