Case 10
| This is a renal cell carcinoma arising in a kidney with dialysis-induced cystic change. Patients with end stage renal disease from any cause who have undergone prolonged dialysis may develop 0.5 to 2 cm cysts in the medulla and/or cortex. Since end stage kidneys are small, the development of cystic change enlarges them back to normal size or slightly greater. Thus, they do not reach the size of kidneys with dominant polycystic kidney disease (DPKD). Like DPKD, the cysts in dialysis-associated cystic change often contain oxalate crystals or hemorrhage. About half of chronic hemodialysis patients will have some cystic renal change after several years, and between 1 and 5% will develop renal cell carcinoma.
| Our winner is: Dr. Jennifer Ramsay of Hamilton, Ontario, CANADA
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