CT and MRI appearances and radiologic staging of pediatric renal cell carcinoma

Downey, Ryan T.; Dillman, Jonathan R.; Ladino-Torres, Maria; McHugh, Jonathan B.; Ehrlich, Peter F.; Strouse, Peter J.

doi:10.1007/s00247-011-2319-5

Cited by 21 publications

(13 citation statements)

References 39 publications

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“…The use of radiology to aid in the staging of patients with RCC is well established in adult patients with RCC, but to the best of our knowledge only limited data are available regarding pRCC . In the current study, the sensitivity for the radiologic determination of LN positivity was poor, missing >42% of subsequently histologically confirmed tumor LN metastases, suggesting that imaging alone is not sufficient to rule out lymph node involvement in patients with pRCC.…”

Section: Discussionmentioning

confidence: 59%

Characterization of adolescent and pediatric renal cell carcinoma: A report from the Children's Oncology Group study AREN03B2

Geller

Ehrlich

Cost

et al. 2015

Cancer

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102

105

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PURPOSE To characterize the epidemiology, histology, radiographic features and surgical approach of pediatric and adolescent renal cell carcinoma (pRCC). PATIENTS AND METHODS pRCC cases prospectively enrolled on the Children's Oncology Group study AREN03B2 underwent central pathology, radiology, surgery and oncology review. RESULTS As of June 2012, of 3250 patients enrolled on AREN03B2, 120 (3.7%) had unilateral RCC (median age 12.9 years, range 1.9-22.1; 52.5% female). Central review classified these as translocation morphology (56), papillary (20), renal medullary carcinoma (13), chromophobe (4), oncocytoma (1), conventional clear cell (1), and RCC not otherwise specified (25). Lymph node (LN) involvement (N+) was found in 35/73 (47.9%) cases for which LN were sampled, including 19/40 (47.5%) with primary tumors < 7cm. Using a size cut-off of 1cm, imaging detection of N+ had a sensitivity of 57.14% [(20/35); 95% CI: 39.35%, 73.68%] and specificity of 94.59% [(35/37); 95% CI: 81.81%, 99.34%]. Distant metastases were present in 23 (19.2%). Initial surgery was radical nephrectomy (RN) in 88 (73.3%), nephron-sparing surgery (NSS) in 18 (15.0%), and biopsy in 14 (11.7%). Patients undergoing NSS compared to RN were less likely to have LNs sampled (6/18 (33.3%) vs. 65/88 (73.9%), p-value = 0.002). CONCLUSIONS Translocation RCC is the most common form of pediatric and adolescent RCC. Nodal disease is common and seen with small primary tumors. Imaging has a high specificity but relatively low sensitivity for detection of such lymph node disease. Failure to sample LNs results in incomplete staging and potentially inadequate disease control for younger RCC patients.

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Section: Discussionmentioning

confidence: 59%

Characterization of adolescent and pediatric renal cell carcinoma: A report from the Children's Oncology Group study AREN03B2

Geller

Ehrlich

Cost

et al. 2015

Cancer

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102

105

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“…Robot-assisted laparoscopic approach to partial nephrectomy has been reported to have a potential advantage of allowing improved visualization for lymph node dissection [7]. Certain radiographic findings suggest a diagnosis of RCC, including post-contrast enhancement, associated hemorrhage, or internal calcification [8]. Low renal nephrometry scores, a tool for predicting tumor complexity and difficulty of partial nephrectomy, may also indicate RCC and thus a patient for whom nephron sparing could be appropriate [9].…”

Section: Discussionmentioning

confidence: 97%

Practice patterns and outcomes of pediatric partial nephrectomy in the United States: Comparison between pediatric urology and general pediatric surgery

Suson

Wolfe‐Christensen

Elder

et al. 2015

Journal of Pediatric Urology

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“…64 La diferenciación con otras neoplasias renales requiere de estudio inmunohistoquímico, y las imágenes por tomografía computarizada (TC) con frecuencia demuestran una masa heterogénea, circunscrita o no, con menor densidad respecto al tejido renal normal adyacente, con frecuencia de calcificaciones hasta el 25% de los casos y de mayor tamaño que el AM. 65 Puede presentar invasión vascular, y se le puede encontrar envuelta en una pseudocápsula que en ocasiones se calcifica. 1,61 En MRI se observa baja señal en T y T2, dado a que el pCCR posee menor MVD, asimismo, posterior al contraste, se intensifica menos que el tejido renal adyacente.…”

Section: Discussionunclassified

Una masa renal poco común en una adolescente – presentación de caso y revisión de la literatura

2019

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Introducción Las neoplasias renales en la población pediátrica y adolescente son raras, entre el 6% y el 7% de las masas en pediatría. En adolescentes plantea un desafío clínico importante. Presentan variables manifestaciones sistémicas inespecíficas o cuadros asintomáticos. En la literatura se han identificado el Carcinoma de Células Renales y el Tumor de Wilms como las masas renales más prevalentes en menores de 20 años, el Adenoma Metanéfrico es una entidad muy poco común en esa población. Presentación de caso Adolescente, con dolor en flanco izquierdo y hematuria macroscópica monosintomática, estudios imagenológicos evidencian lesión de aspecto neoplásico renal izquierda, que al complementarse con estudios de inmunohistoquímica resulta en Adenoma Metanéfrico. Se realiza revisión de literatura publicada en las últimas tres décadas al respecto. La paciente es llevada a nefrectomía radical izquierda, y posteriormente el estudio anatomopatológico sugiere Adenoma Metanéfrico, con marcadores de inmunohistoquímica que corroboran el hallazgo. Conclusiones Los tumores renales en adolescentes son raros. Se requiere de alta sospecha clínica, un examen físico meticuloso y el apoyo en imágenes diagnósticas. Generalmente, el estudio histopatológico determina el diagnóstico definitivo, no obstante, cuando persiste la confusión, se recurre a la inmunohistoquímica. El Carcinoma de Células Renales es el más prevalente de los tumores renales en adolescentes, pero existen entidades indistinguibles al estudio imagenológico que plantean un desafío clínico; es el objetivo brindar una herramienta de apoyo en el abordaje del Adenoma metanéfrico e instar al desarrollo de conocimiento sobre una entidad patológica en ese grupo etario que ha sido poco documentado que indudablemente redundará en mejores prácticas e impacto científico, social y económico.

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CT and MRI appearances and radiologic staging of pediatric renal cell carcinoma

Abstract: Pediatric RCCs typically present as large, heterogeneous masses, and they commonly hemorrhage and contain internal calcification. Radiologic and surgicopathological overall TNM staging are frequently concordant, although radiologic T staging is often incorrect.

Cited by 21 publications

References 39 publications

Characterization of adolescent and pediatric renal cell carcinoma: A report from the Children's Oncology Group study AREN03B2

Characterization of adolescent and pediatric renal cell carcinoma: A report from the Children's Oncology Group study AREN03B2

Practice patterns and outcomes of pediatric partial nephrectomy in the United States: Comparison between pediatric urology and general pediatric surgery

Una masa renal poco común en una adolescente – presentación de caso y revisión de la literatura

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