Antenatal ultrasound at 28 weeks shows a unilateral multicystic mass in the fetal flank with multiple noncommunicating cysts of varying size and no demonstrable renal pelvis. Postnatal DMSA scan shows no uptake on that side. What is the standard approach in an asymptomatic infant?
- A Conservative follow-up with serial ultrasound and blood pressure monitoring ✓
- B Routine nephrectomy in infancy
- C Open biopsy to exclude Wilms tumor
- D Contralateral pyeloplasty to protect function
Correct answer: A. Conservative follow-up with serial ultrasound and blood pressure monitoring
Explanation
Multicystic dysplastic kidney is a nonfunctioning dysplastic kidney with noncommunicating cysts, usually detected antenatally and confirmed by absent uptake on DMSA or MAG3 scan. In asymptomatic children it involutes over time and current practice is conservative follow-up with serial ultrasound and blood pressure monitoring. Routine nephrectomy is no longer advised, malignancy risk is very low, and the contralateral kidney needs surveillance for obstruction or reflux rather than surgery.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.