| A 75-year-old woman presented with a medical history of allergy to salicylates. | |
| At 59 years old, she was diagnosed with fever of probable specific etiology, treated with tuberculous meningitis, according to the usual pattern. | |
| In 1998 she was diagnosed with familial Mediterranean fever after excluding other processes. | |
| Osteoporosis. | |
| She is being treated with Colchicine (0.5 mg/day), NSAIDs (50 mg/day), acetaminophen (6 mg/day) and omeprazole. | |
| Current history: The patient had a casual fall in October 2002 on left flank presenting 10 days after an episode of monosymptomatic hematuria. | |
| In May 2003, the patient had fever and left lumbar pain and was admitted to a hospital where an abdominal CAT scan was performed, which showed left hypernephroma with normal right kidney. | |
| It's treated with quinolones. | |
| No culture is performed. | |
| At the time of consultation she is asymptomatic, without fever, or low back pain. | |
| Location: not known abdominal masses. | |
| Analytical: Hemoglobin 12.3. | |
| Poison control 1. | |
| Leukocytes 11,200 (Neutral follicles 76), urea, creatinine, BT, BD, GOT and GPT are normal. | |
| Urine sediment, 10-15 leukocytes/field | |
| Urinocultiva: E. Coli. | |
| Renal ultrasound: 12 cm solid-cystic left renal mass compatible with hypernephroma. Normal right kidney. | |
| Abdominal CT: (10-06-03) Mass on the lateral side of the left kidney that causes a displacement and horizontalization of the kidney that has a maximum diameter of 12 cm presenting large cystic areas and even a solid component central tumor should be treated. | |
| Another possibility is that it is a cystic nephroma, but in any case the lesion is tumor-like and has a poorly defined contour, so it seems that there is posterior thickening of the abdominal wall at the perirenal solid region above the lumbar lesion. | |
| Normal right kidney. | |
| Hepatic ilioadenopathy greater than 1 cm. | |
| The patient was scheduled for outpatient preoperative study and nephrectomy. | |
| On 25-06-03, the patient was admitted for fever of 38oC and moderate low back pain without affecting the general condition. | |
| Location: left lumbar mass. | |
| Location: positive left renal percussion. | |
| Analytical: Hemoglobin 9.9. | |
| Cholestasis 28.1. | |
| Leukocytes 18,400. | |
| Neurils 87.6. | |
| Box 5. | |
| Platelets 328,000. | |
| Urea, Creatinine and liver function tests were normal. | |
| Urine sediment, 100 leukocytes / field. | |
| Urinocultiva: E. Coli. | |
| An abdominal ultrasound was performed which reported a large solid, heterogeneous, polylobulated mass with cystic areas occupying the lower two thirds of the left kidney and extending to the posterior abdominal palatine and contacting the posterior abdominal wall. | |
| An abdominal CT is reported as a complex mass in relation to the lower pole of the left kidney Figures 2 and 3. This mass has irregular edges, mixed density, with areas of high density and other truly cystic. | |
| The mass grows outside the renal cell inserting the posterior pararenal space and connecting the abdominal wall at the level of the oblique and transverse iliac muscles in the upper border of the a. | |
| The caudal cranial diameter of the mass is 12 cm and shows a similar diameter. | |
| A drainage of cystic areas is placed leaving abundant pus. | |
| The culture of drained pus is E. Coli. | |
| Treatment with 200 mgr/every 12 hours Ciprofloxacin IV. | |
| 4-07-03 underwent left nephrectomy by lumbotomy without incidents. | |
| The anatomopathological diagnosis shows polygonal or spindle cell histiocytic cells eosinophilia with Michaelis-Gutmann bodies and accompanying lymphocytes. | |
| The postoperative course was uneventful. | |
| Treatment with oral ciprofloxacin was continued at usual doses for one month. | |