A 75-year-old patient was admitted to our department of urology for three years persisting anorexia, progressive weight loss, dehydration and indeterminate significant abdominal distension. Patient was treated for pulmonary tuberculosis, arterial hypertension and hypercholesterolemia. He had no urological symptoms. Physical examination revealed a normal blood pressure, a ballotable mass arising from beneath the costal margin, extending across the midline and into the pelvis. The abdomen was painless on palpation and percussion, the abdominal wall was tough and distended, the prostate was benign. Routine hematology, biochemistry, and serum tumor markers were within normal limits. Voluminous ascites was described on ultrasonographic examination of abdomen. An abdominal paracentesis was performed and gained about 2000 ml of roily brownish fluid without any complications. Fluid's laboratory examination concluded to transudate with negative microbiological tests and no cytological evidence of malignancy. Computed tomography of his abdomen revealed bilateral simple renal cysts with an exceptionally giant sized renal cysts measuring 35 x 32 x 22 cm on the right kidney (Figure  1). The size of the left renal cysts was 6 cm. The cysts had oval shape, good acoustic enhancement, no internal echoes, and sharply marginated smooth walls. The right giant cyst was shifting the kidney to the midline. The kidney parenchyma was preserved. Treatment consisted of continuous percutaneous catheter drainage with negative pressure on the right kidney, and simple aspiration with sclerotherapy on the left kidney; 8 liters of fluid were removed with negative cytology. The patient reported rapid weight loss of 6 kg and restoration of appetite within days; there were no major post-operative complications. Subsequent Computed tomography after six months revealed quasi-normal aspect of the cysts (Figure  2), and the patient remained asymptomatic.