title: Diagnostic and therapeutic challenges of an ambiguous cystic kidney disease in a resource limited setting: a case report.
abstract: BACKGROUND
  Unilateral renal cystic disease is a rare condition that shares morphological similarities with multicystic dysplastic kidney, the former often distinguished from the latter on some clinical and histopathological grounds. However serious diagnostic and therapeutic dilemmas set in when there is a considerable overlap in the distinguishing features between these entities.
  
  
  METHODS
  A 19-year-old African female presented with a chronic severe debilitating right lower quadrant abdominal pain refractory to analgesics. Biochemical investigations and imaging studies revealed a non-functional polycystic right kidney and no identifiable pelvicalyceal system or ureter but with preserved renal function. The marked overlap in clinical presentation between unilateral renal cystic disease and multicystic dysplastic kidney in this patient necessitated further investigation to pose an appropriate diagnosis. A right nephrectomy was performed and histopathological analysis of the resected kidney done, the results of which were more consistent with unilateral renal cystic disease. The post-operative course was favorable.
  
  
  CONCLUSIONS
  Unilateral renal cystic disease with an ipsilateral non-functional kidney and an atretic pelvicalyceal system is a very rare condition that needs to be distinguished from multicystic dysplastic kidney in order to guide management and set prognosis. A suspicion of either of these diseases therefore warrants a thorough clinical evaluation and the appropriate combination of biochemical and imaging investigations.
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. akdimch@yahoo.com.|Orthopaedics Department, Southend University Hospital, Essex, UK. akdimch@yahoo.com.|Health and Human Development (2HD) Research Group, Douala, Cameroon. akdimch@yahoo.com.
authors.forename: Christian Akem
authors.initials: CA
authors.lastname: Dimala
authors.affiliation: Penka Michel District Hospital, Penka-Michel, Cameroon.
authors.forename: Ndemazie Nkafu
authors.initials: NN
authors.lastname: Bechem
authors.affiliation: Presbyterian General Hospital Acha-Tugi, Acha, Cameroon.
authors.forename: Benjamin Momo
authors.initials: BM
authors.lastname: Kadia
authors.affiliation: Health and Human Development (2HD) Research Group, Douala, Cameroon.|Mboppi Baptist Hospital, Douala, Cameroon.
authors.forename: Vitalis Fambombi
authors.initials: VF
authors.lastname: Feteh
authors.affiliation: Health and Human Development (2HD) Research Group, Douala, Cameroon.|Faculty of Health Sciences, University of Buea, Buea, Cameroon.|Douala General Hospital, Douala, Cameroon.
authors.forename: Simeon Pierre
authors.initials: SP
authors.lastname: Choukem
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006295:Health Resources / Q000592:standards*; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000000981:diagnostic imaging* / Q000601:surgery*; D009392:Nephrectomy / Q000379:methods*; D007690:Polycystic Kidney Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
keywords: Cameroon; Diagnosis; Multicystic dysplastic kidney; Unilateral renal cystic disease