Diagnostic and therapeutic challenges

A laparoscopic cholecystectomy on a 63-year-old woman was uneventful. Twenty-one months after the operation she complained of dull right flank pain, loss of appetite, weight loss, and cough. CT of the abdomen showed an 8.5 cm mass adjacent to the posterior aspect of the upper pole of the right kidney. CT also demonstrated a small calcification (5 mm diameter) posterior to the upper pole of the right kidney. The patient underwent exploratory laparotomy 2 months after the presentation with flank pain. Examination of the mass showed a thick abscess wall and 250 mL of pus. The patient's symptoms improved after the abscess was drained.