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the clinical history and investigation could raise the possibility of malignant disease in differential diagnoses .
young adult known case of essential hypertension on medication started to complain of bilateral flank pain which was intermittent not severe localized to his flank with no other symptoms .
his laboratory investigation came pack normal he underwent abdominal ultrasound initially , which showed bilateral cystic renal masses images in fig .
1 , ct scan done for further evaluation , which shows the same finding of non - enhancing cystic renal masses images in fig .
the diagnosis being discussed with the patient himself after explaining the rarity of disease and management options available in the clinic and ease of follow up he decided for not persue any active surgical intervention with regular follow up in our out patient clinics
no active surgical intervention were offered to the patient based on his request except analgesic medications as needed .
renal lymphoangiomatosis , rare benign congenital anomaly due to failure of lymphatic system around the kidney to drain to retroperitoneal lymphatic system , which will cause dilation of lymphatic duct and formation multiple cystic lesion in perinephric space and renal sinus .
it might be familial , . this rare anomaly can be asymptomatic or can present as flank pain , hypertension , hematuria and prtienuria .
the diagnosis of renal lymphangimatosis can be confirmed with needle aspiration of cystic fluide but the radiological feature can make the clinician make the diagnosis confidently , .
the reported complication of renal lymphohangiomatosis are obstructive uropathy   secondary hypertension due to obstruction and mass effect of the lesion .
pregnancy can be an exacerbating factor for this disease by increasing the cyst size and fluid collection .
percutaneous drainage has proved it 's effectiveness in treating symptomatic patient and pregnant women , .
1.renal lymphangiomatsis is extremely rare disease with no sexual difference or age group tendency.2.can be asymptomatic or symptomatic due to the cyst it self or it 's mass effect.3.radiological finding can help in making the diagnosis with no need for invasive procedure.4.usually require no treatment unless in specific condition .
can be asymptomatic or symptomatic due to the cyst it self or it 's mass effect .
alqahtani , raed primary author alkhateeb , sultan secondary author who supervise the review almutaiti , bader the radiologist who report the image and made the diagnoses .
highlightsrenal lymphangiomatosis is a rare congenital benign disease of renal lymphatic system.here we are presenting a very rare form of disease , which is bilateral form.disease can be found incidentally or with different signs and symptoms.initial radiological work up will raise suspicion of renal tumor.disease can be diagnosed and followed by imaging with an expert radiologist.management usually analgesia unless a complex case or directed to the complications .