Radiologic Evaluation of Small Renal Masses (I): Pretreatment Management

Marhuenda, Ana; Martin, M.; Deltoro, C.; Santos, Juliana dos; Briones, J. Rubio

doi:10.1155/2008/415848

Cited by 10 publications

(10 citation statements)

References 111 publications

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“…The reported incidences of benign pathological lesions with a tumor diameter of ≤40 mm were 17.3-23.4% in studies from Western countries (5,6,(19)(20)(21)(22)) and 7.1-15.0% in studies from Asian countries (7,8,23). Fujii et al suggested that one possible reason for the lower incidence of benign pathological findings in Asian than Western countries was the low incidence rate of oncocytoma in Asia (7), which is indistinguishable from RCC using the present imaging modalities (24). The reported incidence rates of oncocytoma in small renal masses were 5.7-10.7% in Western countries (5,6,19-22) but 1.3-2.8% in Asian countries (7,8,23), consistent with the results of the present study (1.5%).…”

Section: Discussionmentioning

confidence: 71%

Diagnostic accuracy of pre-operative imaging findings in presumed clinical T1a renal cell carcinomas

et al. 2016

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Abstract. Despite the development of recent imaging modalities, certain pathological misdiagnoses remain for surgical specimens of presumed small renal cell carcinomas (RCCs). In the present study, a retrospective analysis of benign pathological lesions diagnosed as small RCC prior to surgery was performed. In total, the cases of 196 sporadic renal tumors that was surgically treated as clinical T1a RCCs were reviewed, and the accuracy of the pathological diagnoses was calculated. The pre-operative findings for benign pathological lesions was investigated, and the lesions were observed in 13 (6.63%) of the 196 tumors. Pre-operative computed tomography images were obtained in all cases, and magnetic resonance images were available in 10 cases. The diagnostic accuracy of imaging modalities was significantly lower in the tumors with a diameter of ≤20 mm. In all cases, the possible pathological diagnosis of RCC could not be excluded even by retrospective imaging analysis. Several benign pathological lesions were found in small renal masses presumed to be clinical T1a RCC. In conclusion, there may be limitations to the pre-operative imaging for certain types of small renal mass.

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Section: Discussionmentioning

confidence: 71%

Diagnostic accuracy of pre-operative imaging findings in presumed clinical T1a renal cell carcinomas

et al. 2016

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“…However, making a definitive diagnosis in SRM remains difficult. Angiomyolipoma (AML) is typically a solid benign lesion that exhibits fat density on CT scans [12]. However, some renal lesions may contain a very small amount of fat ("minimal fat AML") with microscopic fat and without demonstrable macroscopic fat; these lesions cannot be differentiated from RCCs.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of the Ice-Cream Cone Pattern in Computed Tomography for Prediction of Angiomyolipoma in Patients With a Small Renal Mass

et al. 2013

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PurposeA morphologic contour method for assessing an exophytic renal mass as benign versus malignant on the basis of the shape of the interface with the renal parenchyma was recently developed. We investigated the usefulness of this morphologic contour method for predicting angiomyolipoma (AML) in patients who underwent partial nephrectomy for small renal masses (SRMs).Materials and MethodsFrom January 2004 to March 2013, among 197 patients who underwent partial nephrectomy for suspicious renal cell carcinoma (RCC), the medical records of 153 patients with tumors (AML or RCC) ≤3 cm in diameter were retrospectively reviewed. Patient characteristics including age, gender, type of surgery, size and location of tumor, pathologic results, and specific findings of the imaging study ("ice-cream cone" shape) were compared between the AML and RCC groups.ResultsAML was diagnosed in 18 patients and RCC was diagnosed in 135 patients. Gender (p=0.001), tumor size (p=0.032), and presence of the ice-cream cone shape (p=0.001) showed statistically significant differences between the AML group and the RCC group. In the multivariate logistic regression analysis, female gender (odds ratio [OR], 5.20; 95% confidence interval [CI], 1.45 to 18.57; p=0.011), tumor size (OR, 0.34; 95% CI, 0.12 to 0.92; p=0.034), and presence of the ice-cream cone shape (OR, 18.12; 95% CI, 4.97 to 66.06; p=0.001) were predictors of AML.ConclusionsThis study confirmed a high incidence of AML in females. Also, the ice-cream cone shape and small tumor size were significant predictors of AML in SRMs. These finding could be beneficial for counseling patients with SRMs.

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“…MRI is performed usually during end-expiratory breath-hold and subsequently requires patient cooperation and ability to do so [15,16]. During an MRI, provided there are no contraindications, intravenous gadolinium is administered.…”

Section: Magnetic Resonance Imaging In the Diagnosis Of Srmmentioning

confidence: 99%

Magnetic Resonance Imaging and the Use in Small Renal Masses

Vedanayagam

Bhattacharya

Sriprasad

2016

Indian J Surg Oncol

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The incidence of small renal masses (SRM) has been increasing, and this is mainly attributed to the incidental finding of such masses on imaging performed in asymptomatic patients. Consequently, this calls for careful evaluation and management of these masses to determine their nature and need for treatment. This article reviews current literature regarding the evaluation and management of SRM. It focuses on the specific use of MRI in the diagnosis and management of SRM. A Medline review of the literature was performed from 1996 to the present time. Computed tomography (CT) imaging has been the investigation of choice for evaluating SRM. However, some remain difficult to determine their malignant or benign nature and remain indeterminate. In such cases, further imaging with magnetic resonance imaging (MRI) can be performed to evaluate the mass in more detail. It can also be used where CT is contraindicated and where active surveillance is the treatment of choice and radiation exposure is a concern. MRI is a useful tool in evaluating an indeterminate small renal mass. Accurate diagnosis and management of SRM require close collaboration between a urologist and radiologist to identify potentially malignant tumours to subsequently reduce mortality from renal cell cancer.

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Radiologic Evaluation of Small Renal Masses (I): Pretreatment Management

Cited by 10 publications

References 111 publications

Diagnostic accuracy of pre-operative imaging findings in presumed clinical T1a renal cell carcinomas

Diagnostic accuracy of pre-operative imaging findings in presumed clinical T1a renal cell carcinomas

Usefulness of the Ice-Cream Cone Pattern in Computed Tomography for Prediction of Angiomyolipoma in Patients With a Small Renal Mass

Magnetic Resonance Imaging and the Use in Small Renal Masses

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