A 47-year-old woman visited the urology department after right-sided renal colic accompanied by haematuria. She was being treated with diclofenac for osteoarthritis and low back pain.
X-ray and ultrasound showed a lithiasis in the middle calcific group of the right kidney and a giant renal cyst. A CT scan showed the presence of a simple renal cyst (Bosniak I), measuring 17 centimetres and distorting the right kidney, and ipsilateral lithiasis measuring 8 millimetres. Hydatidosis serology was negative. Haemogram within the normal range.

The patient had lumbar discomfort and wanted to be treated for the cyst. She was informed of the different possibilities. Percutaneous drainage and sclerosis of the cyst was pending.
Subsequently, the patient presented with cystitis, and a few days later went to the emergency department for high fever and right lumbar pain. Antibiotic treatment was prescribed at home.
Two months later, when percutaneous drainage was scheduled, the cyst was found to have reduced in size. It measured 6.4 centimetres. In addition, its wall was calcified. It was confirmed by late-slice CT scan that the cyst was communicating with the pyelocaliceal system. Microhaematuria and leucocyturia were present.

Three months later the patient presented with right colic and cystitis. The lithiasis was located in the renal pelvis. The patient had a urinary tract infection with E.coli, which was treated twice, first with Amoxicillin-Clavulanic acid, and then with Trimetropin-Sulfamethoxazole. Finally the infection was cured and the lithiasis was treated by extracorporeal lithotripsy. Since then the patient has been asymptomatic.
One year after the cyst rupture, a CT scan was performed, showing that the lesion measured 2.9 centimetres in diameter, with thick, nodular calcifications and no contrast uptake. Bosniak IIF.

Subsequently, 2 more years have elapsed. Control ultrasound scans, IVUS and CT scan confirm that the appearance of the lesion has not changed. No further communication with the urinary tract has been demonstrated. The patient remains asymptomatic.

