{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T14:35:21Z","timestamp":1768314921719,"version":"3.49.0"},"reference-count":15,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T00:00:00Z","timestamp":1649116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Symptomatic parapelvic cysts (PPC) are rare entities. Our objective is to highlight specific features of PPC to avoid a misdiagnosis of UPJ obstruction. Methods: We retrospectively reviewed the records of children managed between 2012\u20132017. Results: All four patients (18 months\u20138 years) presented with acute renal colic with a large intra-sinusal liquid mass (42\u201385 mm) on ultrasound, evoking a diagnosis of UPJ obstruction. On preoperative renal scintigraphy (n = 3) there was no dilatation of the renal pelvis and ipsilateral differential function was impaired in 2. Diagnosis of PPC was suspected preoperatively in three children (CT scan (n = 1); MRI (n = 2)) and made peri-operatively (n = 1). Preoperative retrograde pyelography (n = 3) and a further intraoperative retrograde pyelography with methylene blue (n = 1) did not identify communication with the cyst. No renal pelvis was identified in two patients. De-roofing of the cyst was curative in all cases at 5 years mean follow-up (no leakage, cyst recurrence or loss of function) and all 4 patients became asymptomatic after surgery. Histology demonstrated a single flat epithelial cell layer. Renal function normalized in one patient but remained impaired in the other. Conclusion: In case of symptoms of UPJ obstruction with a medial renal liquid mass on ultrasound, PPC should be considered when no dilatated pelvis on renal scan is identified. In such cases, a complementary imaging work-up is mandatory prior to surgery.<\/jats:p>","DOI":"10.3390\/jcm11072035","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T11:26:07Z","timestamp":1649157967000},"page":"2035","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Symptomatic Parapelvic Cysts in Children: Anatomical and Histological Features, Diagnostic Pitfalls and Urological Management"],"prefix":"10.3390","volume":"11","author":[{"given":"Jean-Baptiste","family":"Marret","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery and Urology, H\u00f4pital Necker Enfants Malades, APHP, Universit\u00e9 de Paris, 149 Rue de S\u00e8vres, 75015 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Blanc","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery and Urology, H\u00f4pital Necker Enfants Malades, APHP, Universit\u00e9 de Paris, 149 Rue de S\u00e8vres, 75015 Paris, France"},{"name":"Mechanisms and Therapeutic Strategies of Chronic Kidney Disease, INSERM U1151-CNRS UMR 8253, Institut Necker Enfants Malades, D\u00e9partement \u201cCroissance et Signalisation\u201d, H\u00f4pital Necker Enfants Malades, Universit\u00e9 de Paris, 149 Rue de S\u00e8vres, 75015 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andre","family":"Balaton","sequence":"additional","affiliation":[{"name":"Department of Pathology, Praxea Diagnostics, 1 Rue Galvani, 91300 Massy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7113-2372","authenticated-orcid":false,"given":"Sandro","family":"La Vignera","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guido","family":"Zangh\u00ec","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henri Bernard","family":"Lottmann","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery and Urology, H\u00f4pital Necker Enfants Malades, APHP, Universit\u00e9 de Paris, 149 Rue de S\u00e8vres, 75015 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Bagnara","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Policlinico \u201cG.B. Morgagni\u201d, Via Del Bosco 105, 95125 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1055\/s-2005-873073","article-title":"The parapelvic renal cyst. A rare aetiology of blood hypertension in children","volume":"16","author":"Dobremez","year":"2006","journal-title":"Eur. J. Pediatric Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1542\/peds.65.4.821","article-title":"Hypertension and hematuria secondary to parapelvic cyst","volume":"65","author":"Chan","year":"1980","journal-title":"Pediatrics"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.juro.2016.09.160","article-title":"Bosniak Classification for Complex Renal Cysts Reevaluated: A Systematic Review","volume":"198","author":"Schoots","year":"2017","journal-title":"J. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1148\/radiol.2018181243","article-title":"Imaging of Kidney Cysts and Cystic Kidney Diseases in Children: An International Working Group Consensus Statement","volume":"290","author":"Gimpel","year":"2019","journal-title":"Radiology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1007\/s00247-011-2113-4","article-title":"Caliceal diverticulum in pediatric patients: The spectrum of imaging findings","volume":"41","author":"Karmazyn","year":"2011","journal-title":"Pediatric Radiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1016\/j.juro.2008.10.043","article-title":"Caliceal diverticula in children: Natural history and management","volume":"181","author":"Estrada","year":"2009","journal-title":"J. Urol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/j.urology.2004.11.012","article-title":"Laparoscopic management of peripelvic renal cysts: University of California, San Francisco, experience and review of literature","volume":"65","author":"Camargo","year":"2005","journal-title":"Urology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.eucr.2017.11.001","article-title":"A peripelvic renal cyst resulting in clinically symptomatic ureteropelvic junction obstruction","volume":"16","author":"Coggins","year":"2018","journal-title":"Urol. Case Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/BF02388397","article-title":"Parapelvic renal cyst causing UPJ obstruction\u2014Investigation by IVP, ultrasound and CT","volume":"19","author":"Patel","year":"1988","journal-title":"Pediatric Radiol."},{"key":"ref_10","first-page":"71","article-title":"Acute pyelo-ureteral obstruction by an intrasinusal intra- and para-pyelic cyst. Apropos of 3 cases","volume":"102","author":"Houlgatte","year":"1996","journal-title":"J. Urol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1089\/089277901750161836","article-title":"Ureteroscopic decompression of an unusual uroepithelial cyst using the holmium: YAG laser","volume":"15","author":"Liaconis","year":"2001","journal-title":"J. Endourol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1089\/end.2009.0326","article-title":"Ureteroscopic management of symptomatic, simple parapelvic renal cyst","volume":"24","author":"Basiri","year":"2010","journal-title":"J. Endourol."},{"key":"ref_13","first-page":"1070","article-title":"Retroperitoneal laparoscopic treatment of parapelvic renal cysts: Report of 5 cases","volume":"15","author":"Rabii","year":"2005","journal-title":"Prog. Urol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/BF00171191","article-title":"Pyelocaliceal diverticulum presenting as pelviureteric junction obstruction","volume":"10","author":"Lakhoo","year":"1995","journal-title":"Pediatric Surg. Int."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1111\/j.1464-410X.1980.tb03056.x","article-title":"The Parapelvic Renal Cyst: A Report of 8 Cases with Particular Emphasis on Diagnosis and Management","volume":"52","author":"Androulakakis","year":"1980","journal-title":"Br. J. Urol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/7\/2035\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:48:37Z","timestamp":1760136517000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/7\/2035"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,5]]},"references-count":15,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["jcm11072035"],"URL":"https:\/\/doi.org\/10.3390\/jcm11072035","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,5]]}}}