Multi Cystic Dysplastic Kidneys (MCDK)
In this problem the entire kidney is replaced by a group of fluid filled cysts. It can present in two ways
Diagnosed before birth (antenatal scans)
Mass felt on examination
Ultrasound scan reveals multiple cysts and there is no function on that kidney when tested on DMSA scan. A vast majority of them resolve spontaneously. They may be associated with problems in the opposite kidney (reflux) which may require further tests. If the MCDK is causing pain, infection or hypertension, or if it fails to resolve then an operation is required to remove it. Laparoscopic surgery is possible to remove these.
Cysts - Wilms Tumour
It often presents as a painless mass on routine examination of the child presenting with common cold and fever. It can also present with pain, fever or blood in urine. The child rapidly loses appetite and weight. CT scan is required to confirm the tumour and extent of spread.
Surgery is the mainstay of treatment supplemented by chemotherapy (anti cancer drugs). Unlike adult cancers, it has a very good survival rate when treated carefully.
Cysts - Testicular Tumours
Young children and adolescent boys can develop tumour of testis which often presents as painless swelling of testis. Surgical removal of testis is required for diagnosis and treatment. With supplementary chemotherapy good survival can be expected.
