Follow-up of renal oncocytoma diagnosed by percutaneous tumor biopsy

Neuzillet, Y.; Lechevallier, É.; Andre, March; Daniel, Laurent; Nahon, Olivier; Coulange, C.

doi:10.1016/j.urology.2005.06.001

Cited by 74 publications

(62 citation statements)

References 17 publications

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“…Nine of the 15 patients underwent biannual ultrasound imaging and were asymptomatic at a mean follow-up time of 49.7 months. Those who underwent surgery were younger and had a significantly higher tumor growth velocity than the non-operative patients (2.4 ± 2.1 mm/yr versus 0.7 ± 0.5 mm/yr., P = 0.008) [21]. …”

Section: Discussionmentioning

confidence: 99%

Bilateral benign renal oncocytomas and the role of renal biopsy: single institution review

et al. 2017

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BackgroundThe goal was to assess the natural history and management of patients with pathologically proven bilateral (synchronous) RO after undergoing initial partial nephrectomy (PN).MethodsAll patients underwent either robotic/laparoscopic or open PN by two experienced genitourinary oncologists from 2005–2013. Final pathology was determined by surgical excision, CT-guided percutaneous core biopsy (CT-biopsy) or fine needle aspiration (FNA). Patient demographics, tumor characteristics (pathologic data, location, size) type of surgery, pre/post estimated glomerular filtration rate (eGFR) and surgical complications were recorded.ResultsTwelve patients were identified with bilateral RO. Median age at the time of surgery was 68 years (46–77) (Table 1). The median size of the largest tumor(s) resected was 2.75 cm (1.5–5.5 cm) and second largest tumor(s) was 1.75 cm (1.0–4.0 cm). Four patients underwent bilateral staged PN and one patient underwent simultaneous bilateral PN (horseshoe kidney). Two patients underwent RFA at the time of biopsy of the contralateral mass after PN. Five patients underwent CT-bx/FNA (5/5) of the contralateral mass followed by active surveillance.Mean follow up was 34 months. There was no significant change in median creatinine pre- and post-operatively. One patient was lost to follow up and one patient died of unknown causes 5 years post-operatively. eGFR decreased an average of 16.96% post-operatively, including a single patient whose eGFR increased by 7.8% after surgery and a single patient whose eGFR did not change (Table 2).ConclusionsPatients with bilateral renal masses and pathologically proven RO can be safely managed with active surveillance after biopsy confirmation of the contralateral mass.

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Section: Discussionmentioning

confidence: 99%

Bilateral benign renal oncocytomas and the role of renal biopsy: single institution review

et al. 2017

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“…Although case reports of coexisting benign pathology and high grade malignancy exist in the literature, these clinical entities appear to be extremely rare. 5,15,16 Furthermore, these data must be interpreted in the context of the recommendation that that Fuhrman grading for chRCC is no longer recommended, as it does not contribute additional prognostic information to TNM staging and to presence of sarcomatoid differentiation. 21,22 …”

Section: Discussionmentioning

confidence: 99%

Coexisting Hybrid Malignancy in a Solitary Sporadic Solid Benign Renal Mass: Implications for Treating Patients Following Renal Biopsy

et al. 2014

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INTRODUCTION AND OBJECTIVES Concern regarding coexisting malignant pathology in benign renal tumors deters renal biopsy and questions its validity. We examined rates of coexisting malignant and high grade pathology in resected benign solid solitary renal tumors. METHODS Using our prospectively maintained database we identified patients with solitary solid renal tumors who underwent surgical resection between 1994 and 2012 (n=1829). Lesions containing elements of renal oncocytoma (RO), angiomyolipoma (AML) or other benign pathology formed the basis for this analysis. Patients having an oncocytic malignancy, without presence of a classic oncocytoma, and those with known hereditary syndromes were excluded. RESULTS 147 patients with pathologically proven elements of RO (n=96), AML (n=44), and other solid benign pathology (n=7) were identified. Median tumor size was 3.0 cm (IQR 2.2 – 4.5) and tumor anatomic complexity, as quantified by the RENAL NS, was low in 28%, moderate in 56%, and high in 16%. Only 4 patients (2.7%) were documented as having hybrid malignant pathology, all involving low grade chromophobe RCC in the setting of RO. After a median follow-up of 44 (IQR 33 – 55) months, no patients with hybrid tumors experienced regional or metastatic progression. CONCLUSIONS In our cohort of patients with a solitary, sporadic, solid benign renal mass, <3% of tumors exhibited coexisting hybrid malignancy. Importantly, no patients harbored coexisting high grade pathology. These data suggest that uncertainty regarding hybrid malignant pathology coexisting with benign pathologic components should not deter renal biopsy, especially in the elderly and comorbid.

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“…FNA with immunocytochemistry analysis can help distinguish between RCC and oncocytomas. Even though RCC may be present in as many as 18% of oncocytomas, a EUS FNA showing oncocytoma, might allow surveillance for a renal lesion, especially if the patient prefers conservative management (13) . Percutaneous renal mass biopsy must not be performed routinely for renal lesions less than 40 mm but it should be indicated for incompletely accurate renal imaging diagnosis after a full imaging evaluation.…”

Section: Discussionmentioning

confidence: 99%

INITIAL EXPERIENCE WITH ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION OF RENAL MASSES: indications, applications and limitations

Moura

Lopes

Srougi

et al. 2014

Arq. Gastroenterol.

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-Context -Tissue sampling of renal masses is traditionally performed via the percutaneous approach or laparoscopicaly.The utility of endoscopic ultrasound to biopsy renal lesions it remains unclear and few cases have been reported. Objectives -To evaluate the feasibility and outcome of endoscopic ultrasound fine needle aspiration of renal tumors. Method -Consecutive subjects undergoing attempted endoscopic ultrasound fine needle aspiration of a kidney mass after evaluation with computerized tomography or magnetic resonance. Results -Ten procedures were performed in nine male patients (median age 54.7 years) on the right (n = 4) and left kidney (n = 4) and bilaterally (n = 1). Kidney masses (median diameter 55 mm ; range 13-160 mm) were located in the upper pole (n = 3), the lower pole (n = 2) and the mesorenal region (n = 3). In two cases, the mass involved more than one kidney region. Surgical resection confirmed renal cell carcinoma in six patients in whom pre-operative endoscopic ultrasound fine needle aspiration demonstrated renal cell carcinoma. No complications were reported. Conclusions -Endoscopic ultrasound fine needle aspiration appears as a safe and feasible procedure with good results and minimal morbidity. HEADINGS -Kidney neoplasms, diagnosis. Ultrasonography. Endoscopic ultrasound-guided fine needle aspiration.

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Follow-up of renal oncocytoma diagnosed by percutaneous tumor biopsy

Cited by 74 publications

References 17 publications

Bilateral benign renal oncocytomas and the role of renal biopsy: single institution review

Bilateral benign renal oncocytomas and the role of renal biopsy: single institution review

Coexisting Hybrid Malignancy in a Solitary Sporadic Solid Benign Renal Mass: Implications for Treating Patients Following Renal Biopsy

INITIAL EXPERIENCE WITH ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION OF RENAL MASSES: indications, applications and limitations

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