A 74-year-old woman presented with a 3-day history of fever and left flank pain. The imaging study revealed a huge complicated cyst in the left kidney. The cyst had a mass effect to the abdomen. We performed laparoscopic renal cyst unroofing. The histopathologic examination disclosed renal tuberculosis of the cyst wall and cystic fluid. Renal tuberculosis is not uncommon; however, renal tuberculosis presenting as a renal cyst is very rare.
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