Cyst fluid creatinine and histopathology confirm congenital giant hydronephrosis in a 60-year-old manSurgery reveals rare cause for large abdominal mass in adult

Frontiers in Medicine Published September 30, 2026 DOI ↗ Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

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Key Takeaway

Consider cyst fluid creatinine and histopathology when evaluating adult retroperitoneal cystic masses.

This is a case report with an accompanying literature review focused on the diagnostic workup and surgical management of a large retroperitoneal cystic mass in an adult. The patient was a 60-year-old man with a 10-year history of the mass. The intervention described was complete surgical resection of the cystic lesion.

The diagnosis of congenital giant hydronephrosis was confirmed by cyst fluid creatinine and postoperative histopathology. The patient recovered uneventfully without complications during regular follow-up. No adverse events or serious adverse events were reported. Follow-up duration was not reported.

The authors state that the report provides a reference for clinicians to distinguish retroperitoneal cystic masses and to optimize surgical decision-making for adult giant congenital hydronephrosis. No comparator, effect size, or statistical measures were reported.

The main limitation acknowledged is the small sample size, specifically a single case report. The authors caution that the findings are not generalizable to the broader population of adults with retroperitoneal cystic masses. Funding and conflicts of interest were not reported.

Imagine living with a large, mysterious growth in your abdomen for a decade. For a 60-year-old man, this mass was a constant presence for 10 years before doctors finally identified what it was. The mass was located in the retroperitoneal space, an area deep in the abdomen.

Doctors performed a complete surgical removal of the cyst. After the surgery, they tested the fluid and looked at the tissue under a microscope. These tests confirmed the diagnosis of congenital giant hydronephrosis. This is a condition where a kidney is enlarged by a large cyst that has been present since birth.

While this case is very rare in adults, the surgery was successful. The patient recovered without any complications during his regular follow-up. Because this was a single case, we cannot know if this outcome would be the same for everyone, but it helps doctors better identify and treat similar masses in their patients.

What this means for you:

A large abdominal mass in an adult was found to be a rare, lifelong kidney cyst.

Common questions

What was the actual cause of the large mass?

The mass was confirmed to be congenital giant hydronephrosis. This is a condition where a large cyst develops in the kidney. Because it is congenital, it means the condition was present from birth, even though it was only discovered in this patient at age 60.

Was the surgery successful for the patient?

Yes, the patient underwent a complete surgical removal of the cyst. He recovered uneventfully and had no complications during his regular follow-up after the procedure.

How common is this condition in adults?

This is a very rare finding in adults. Because this report only looks at one specific case, the results cannot be applied to everyone with a similar mass. You should talk to a doctor to discuss specific medical concerns.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedSep 2026

View Original Abstract ↓

Giant retroperitoneal cystic lesions encompass multiple differential diagnoses including renal cysts, lymphangiomas and congenital hydronephrosis. Congenital giant hydronephrosis is extremely rare in adult patients, with limited clinical data to guide preoperative differentiation and surgical management. We report a unique case of a 60-year-old male with a 10-year history of progressive giant left retroperitoneal cystic mass, accompanied by left abdominal distending pain. Preoperative contrast-enhanced ultrasound and CT demonstrated severe left hydronephrosis with markedly atrophic renal cortex. Complete surgical resection of the cystic lesion was performed under laparotomy. Cyst fluid creatinine and postoperative histopathology confirmed the diagnosis of congenital giant hydronephrosis. The patient recovered uneventfully without complications during regular follow-up. We further review published literature to summarize clinical manifestations, multimodal imaging differentiation, surgical indications and long-term prognosis of adult giant congenital hydronephrosis, aiming to provide practical references for clinicians to distinguish retroperitoneal cystic masses and optimize surgical decision-making.

Cyst fluid creatinine and histopathology confirm congenital giant hydronephrosis in a 60-year-old manSurgery reveals rare cause for large abdominal mass in adult

Common questions

Study Details

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Cyst fluid creatinine and histopathology confirm congenital giant hydronephrosis in a 60-year-old manSurgery reveals rare cause for large abdominal mass in adult

Common questions

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