A practical guide and decision-making protocol for the management of complex renal cystic masses

Weibl, Peter; Hora, Milan; Kollarik, Boris; Kalusová, Kristýna; Pitra, Tomáš; Remzi, Mesut; Hübner, W.; Balzer, Pascal; Klatte, Tobias

doi:10.1016/j.aju.2017.02.001

Cited by 8 publications

(3 citation statements)

References 25 publications

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“…Intravenous urography is an effective imaging method for diagnosis of medullary sponge kidney and ADPKD, which seen with thin prolonged calyces described as a spider-leg deformity; it determines the obstruction level and renal excretion (11,17,27) . CT scan is very sensitive imaging study for the diagnosis and characterizing of simple renal cysts and complex cystic mass with solid components or thick septae with enhancement suspected of renal cell carcinoma, detection of complications and associated abnormalities consistent with reported by Weibi et al in 2017 (28) . Non-contrasted CT urography and US images detects non-radiopaque stones and used in renal failure (29) .…”

Section: Figure 1 Ivu Shows Right Renal Agenesis and Double Left Pelv...supporting

confidence: 79%

Radiological Imaging Diagnosis of Adult Renal Cystic Diseases and Management

Akares¹,

Bahomil²

2020

IraqiJMS

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Background: Renal cysts are a heterogonous group of cystic renal diseases that present in approximately 40% of the patients undergoing imaging. Objective: To describe the role of the radiological imaging methods for the diagnosis of adult renal cystic diseases and their management. Methods: A descriptive study carried out for 218 patients of renal cystic diseases in adults in two Private Hospitals in Aden Province during the period from February 2006 to December 2014, diagnosed by ultrasonography, contrasted urography and computerized tomography determined the age, gender, frequency, and complications and type of treatment. Results: Autosomal dominant polycystic kidney disease (ADPKD) presented in 96 patients (44%), simple renal cysts 90 (41%), medullary sponge kidney 25 (11%), localized cystic renal disease (LCRD) six (3%) and adult multilocular cystic nephroma one (1%). Ultrasound correctly interpreted 179 patients (82%), nonvisualized 25 (11%), and inconclusive 13 (7%) contrasted urography correctly interpreted 176 (76%), nonvisualized 13 (6%) and inconclusive 19 (9%) and computerized tomography (CT) scan 199 patients (91%), six (3%) and 13 (6%) respectively. Complications occurred in 65 patients (68%) of ADPKD, 23 (25%) of simple renal cysts, 15 (60%) of medullary sponge kidney (MSK) and three patients (50%) of LCRD. Conservative treatment performed in 171 (78%) and surgical intervention in 47 patients (22%). Conclusion: The commonest renal cystic disease is adult dominant polycystic kidney. Ultrasound is inconclusive for renal cystic masses. CT scan is the effective imaging study for localized and multifocal renal cystic diseases, complications and associated pathology. The frequent complications occur in adult dominant polycystic kidney disease and medullary sponge kidney. Keywords: Adults, renal cystic diseases, imaging, management Citation: Akares SA, Bahomil AA. Radiological imaging diagnosis of adult renal cystic diseases and management. Iraqi JMS. 2020; 18(1): 12-20. doi: 10.22578/IJMS.18.1.3

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Section: Figure 1 Ivu Shows Right Renal Agenesis and Double Left Pelv...supporting

confidence: 79%

Radiological Imaging Diagnosis of Adult Renal Cystic Diseases and Management

Akares¹,

Bahomil²

2020

IraqiJMS

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“…Typically, the size of tubulocystic RCCs (TCRCC) is small, and approximately 40.0% of them are smaller than 2 cm [ 18 ], unlike the FH-deficient RCC observed in our cases. As reported in the literature, cystic pattern and rim-like or egg-shell calcification are common in Xp11.2/TFE RCC [ 25 26 27 ]. However, the probability of a polycystic shape was higher, and typical calcification was relatively rare in FH-deficient RCC.…”

Section: Discussionmentioning

confidence: 95%

Multidetector CT Characteristics of Fumarate Hydratase-Deficient Renal Cell Carcinoma and Papillary Type II Renal Cell Carcinoma

Yang

Zhang

et al. 2021

Korean J Radiol

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Objective To investigate the multidetector computed tomography (MDCT) features of fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) with germline or somatic mutations, and compare them with those of papillary type II RCC (pRCC type II). Materials and Methods A total of 24 patients (mean ± standard deviation, 40.4 ± 14.7 years) with pathologically confirmed FH-deficient RCC (15 with germline and 9 with somatic mutations) and 54 patients (58.6 ± 12.6 years) with pRCC type II were enrolled. The MDCT features were retrospectively reviewed and compared between the two entities and mutation subgroups, and were correlated with the clinicopathological findings. Results All the lesions were unilateral and single. Compared with pRCC type II, FH-deficient RCC was more prevalent among younger patients (40.4 ± 14.7 vs. 58.6 ± 12.6, p < 0.001) and tended to be larger (8.1 ± 4.1 vs. 5.4 ± 3.2, p = 0.002). Cystic solid patterns were more common in FH-deficient RCC (20/24 vs. 16/54, p < 0.001), with 16 of the 20 (80.0%) cystic solid tumors having showed typical polycystic and thin smooth walls and/or septa, with an eccentric solid component. Lymph node (16/24 vs. 16/54, p = 0.003) and distant (11/24 vs. 3/54, p < 0.001) metastases were more frequent in FH-deficient RCC. FH-deficient RCC and pRCC type II showed similar attenuation in the unenhanced phase. The attenuation in the corticomedullary phase (CMP) (76.3% ± 25.0% vs. 60.2 ± 23.6, p = 0.008) and nephrographic phase (NP) (87.7 ± 20.5, vs. 71.2 ± 23.9, p = 0.004), absolute enhancement in CMP (39.0 ± 24.8 vs. 27.1 ± 22.7, p = 0.001) and NP (50.5 ± 20.5 vs. 38.2 ± 21.9, p = 0.001), and relative enhancement ratio to the renal cortex in CMP (0.35 ± 0.26 vs. 0.24 ± 0.19, p = 0.001) and NP (0.43 ± 0.24 vs. 0.29 ± 0.19, p < 0.001) were significantly higher in FH-deficient RCC. No significant difference was found between the FH germline and somatic mutation subgroups in any of the parameters. Conclusion The MDCT features of FH-deficient RCC were different from those of pRCC type II, whereas there was no statistical difference between the germline and somatic mutation subgroups. A kidney mass with a cystic solid pattern and metastatic tendency, especially in young patients, should be considered for FH-deficient RCC.

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“…Grade IIF is between grades II and III. There are more lesions in grade IIF in clinic, so the diagnosis is relatively difficult (18). Studies have shown that ultrasound combined with Bosniak criteria can improve the diagnostic rate of benign and malignant renal cystic lesions (19).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value and clinical significance of ultrasound combined with CT in cystic renal cell carcinoma

et al. 2019

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This study investigated the value and clinical significance of ultrasound combined with CT in the diagnosis of cystic renal cell carcinoma. A total of 85 patients with cystic renal cell carcinoma, who were admitted to the Oncology Department of Yantai Yuhuangding Hospital Affiliated to Qingdao University from December 2015 to April 2017, were selected as the study group, and 70 patients with benign renal cyst, who were examined in Yantai Yuhuangding Hospital Affiliated to Qingdao University, were selected as the benign group. The patients in the two groups were examined by ultrasound and CT. The diagnostic value of ultrasound, CT, and ultrasound combined with CT in cystic renal cell carcinoma was analyzed. The sensitivity of ultrasound combined with CT was significantly higher than that of CT and ultrasound (P<0.05). The specificity and diagnostic coincidence rate of ultrasound combined with CT were significantly higher than those of CT (P<0.05). For unicapsular kidney cancer, there was no significant difference among ultrasound, CT and ultrasound combined with CT in the diagnosis of septum and wall nodule (P>0.05). For polycystic kidney cancer, there was no significant difference among ultrasound, CT and ultrasound combined with CT in the diagnosis of the presence or absence of septum (P>0.05). Ultrasound was significantly better than CT in cyst wall confounding (P<0.05). Ultrasound combined with CT was significantly better than ultrasound in calcification and blood supply of tumors (P<0.05). In conclusion, the accuracy of ultrasound combined with CT is higher than that of ultrasound or that of CT in the diagnosis of cystic renal cell carcinoma, which can be beneficial in accurately carrying out clinical diagnosis, reduce the incidence of missed diagnosis and misdiagnosis caused by a single diagnosis and treatment. Ultrasound combined with CT is good for clinical screening and can guide clinical symptomatic treatment, which is worthy of generalizing in clinic.

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A practical guide and decision-making protocol for the management of complex renal cystic masses

Cited by 8 publications

References 25 publications

Radiological Imaging Diagnosis of Adult Renal Cystic Diseases and Management

Radiological Imaging Diagnosis of Adult Renal Cystic Diseases and Management

Multidetector CT Characteristics of Fumarate Hydratase-Deficient Renal Cell Carcinoma and Papillary Type II Renal Cell Carcinoma

Diagnostic value and clinical significance of ultrasound combined with CT in cystic renal cell carcinoma

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