A Comprehensive Commentary on the Multilocular Cystic Renal Neoplasm of Low Malignant Potential: A Urologist’s Perspective

Abstract

Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) is a cystic renal tumor with indolent clinical behavior. In most of cases, it is an incidental finding during the examination of other health issues. The true incidence rate is estimated to be between 1.5% and 4% of all RCCs. These lesions are classified according to the Bosniak classification as Bosniak category III. There is a wide spectrum of diagnostic tools that can be utilized in the identification of this tumor, such as computed tomography (CT), magnetic resonance (MRI) or contrast-enhanced ultrasonography (CEUS). Management choices of these lesions range from conservative approaches, such as clinical follow-up, to surgery. Minimally invasive techniques (i.e., robotic surgery and laparoscopy) are preferred, with an emphasis on nephron sparing surgery, if clinically feasible.

Computed tomography (CT) scanned renal cyst and pathological multilocular cystic renal neoplasm of low malignant potential (MCRNLMP): a patients’ management report of 1520 cases

“…Generally speaking, the tumor grade is low, and the number of malignant tumor cells within it is also very small, so the prognosis is relatively good, and there is no obvious correlation between the size of the tumor diameter and the prognosis [7] . For the clinical diagnosis of MCRNLMP, due to the extremely low incidence, and without speci c manifestations in clinical and histopathological aspects, it is di cult to distinguish it from other complex cystic renal tumors in imaging, most of the cases are accidental identi ed, and misdiagnosis or missed diagnosis is highly possible [14] .…”

Multicystic Clear Cell Renal Tumors With Low-grade Nuclear Features: Time to Include TFE3 Translocation-associated Carcinomas

“…1), a subset may show an expansile, solid component and rare cases may be completely solid 9 which are features not compatible with MCNLMP. Therefore, similar to MCNLMP and cystic ccRCC, 17,18 cystic MED15::TFE3 RCC without an expansile, solid component may be on the low-grade end of the spectrum of MED15 :: TFE3 RCC. However, as our case and others have shown, the lack of a solid component does not exclude the possibility of TFE3 -rearranged RCC.…”

“…Most notable is the MCNLMP, formerly known as multilocular cystic renal cell carcinoma. Although the incidence rate of MCNLMP is low, estimated to be between 1.5% and 4% of all RCCs, 16 it is an important diagnostic category with no risk of disease progression or metastases 17,18 …”

Updating Clear Cell Renal Cell Carcinoma (a Tribute to Prof. Ondrej Hes)

“…A commentary in this CCRCC Special Issue refers to the urologist’s perspective of the so-called multilocular cystic renal neoplasm of low malignant potential [ 2 ]. The clinical, radiological, and pathological findings as well as the therapeutic management are reviewed.…”