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Imaging findings of common benign renal tumors in the era of small renal masses: differential diagnosis from small renal cell carcinoma: current status and future perspectives.

Woo S, Cho JY - Korean J Radiol (2015)

Bottom Line: The prevalence of small renal masses (SRM) has risen, paralleling the increased usage of cross-sectional imaging.Therefore, differentiation between early renal cell carcinoma (RCC) and benign SRM is critical to achieve proper management.Furthermore, the role of percutaneous biopsy is discussed as imaging is yet imperfect, therefore necessitating biopsy in certain circumstances to confirm the benignity of SRMs.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea.

ABSTRACT
The prevalence of small renal masses (SRM) has risen, paralleling the increased usage of cross-sectional imaging. A large proportion of these SRMs are not malignant, and do not require invasive treatment such as nephrectomy. Therefore, differentiation between early renal cell carcinoma (RCC) and benign SRM is critical to achieve proper management. This article reviews the radiological features of benign SRMs, with focus on two of the most common benign entities, angiomyolipoma and oncocytoma, in terms of their common imaging findings and differential features from RCC. Furthermore, the role of percutaneous biopsy is discussed as imaging is yet imperfect, therefore necessitating biopsy in certain circumstances to confirm the benignity of SRMs.

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33-year-old woman with small metanephric adenoma.A. Mass at right kidney upper pole is slightly more hyperdense (arrow) than renal parenchyma at axial precontrast CT. B, C. Mass (arrow) is poorly enhancing compared with renal parenchyma at axial corticomedullary phase (B) and early excretory phase (C). Mass was confirmed as metanephric adenoma upon surgical resection.
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Figure 5: 33-year-old woman with small metanephric adenoma.A. Mass at right kidney upper pole is slightly more hyperdense (arrow) than renal parenchyma at axial precontrast CT. B, C. Mass (arrow) is poorly enhancing compared with renal parenchyma at axial corticomedullary phase (B) and early excretory phase (C). Mass was confirmed as metanephric adenoma upon surgical resection.

Mentions: Metanephric adenoma is a rare benign renal tumor which usually occurs in the fifth to sixth decade and is two times more common in females than in males (9). Metanephric adenoma presents as a well-demarcated, round, solid mass on imaging studies (71). On US, it appears as an expansile mass with either hypo- or hyperechogenicity (72). On CT, it appears as a hyperdense mass in relation to adjacent renal parenchyma on precontrast images with weak enhancement (73). These imaging findings overlap with malignant renal tumors such as Wilms tumor and hypovascular renal cell carcinoma (Fig. 5). Calcification is found in 20% of cases. On MR, it shows as hypointense SI on T1-weighted images and slightly hyperintense SI on T2-weighted images (74).


Imaging findings of common benign renal tumors in the era of small renal masses: differential diagnosis from small renal cell carcinoma: current status and future perspectives.

Woo S, Cho JY - Korean J Radiol (2015)

33-year-old woman with small metanephric adenoma.A. Mass at right kidney upper pole is slightly more hyperdense (arrow) than renal parenchyma at axial precontrast CT. B, C. Mass (arrow) is poorly enhancing compared with renal parenchyma at axial corticomedullary phase (B) and early excretory phase (C). Mass was confirmed as metanephric adenoma upon surgical resection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296282&req=5

Figure 5: 33-year-old woman with small metanephric adenoma.A. Mass at right kidney upper pole is slightly more hyperdense (arrow) than renal parenchyma at axial precontrast CT. B, C. Mass (arrow) is poorly enhancing compared with renal parenchyma at axial corticomedullary phase (B) and early excretory phase (C). Mass was confirmed as metanephric adenoma upon surgical resection.
Mentions: Metanephric adenoma is a rare benign renal tumor which usually occurs in the fifth to sixth decade and is two times more common in females than in males (9). Metanephric adenoma presents as a well-demarcated, round, solid mass on imaging studies (71). On US, it appears as an expansile mass with either hypo- or hyperechogenicity (72). On CT, it appears as a hyperdense mass in relation to adjacent renal parenchyma on precontrast images with weak enhancement (73). These imaging findings overlap with malignant renal tumors such as Wilms tumor and hypovascular renal cell carcinoma (Fig. 5). Calcification is found in 20% of cases. On MR, it shows as hypointense SI on T1-weighted images and slightly hyperintense SI on T2-weighted images (74).

Bottom Line: The prevalence of small renal masses (SRM) has risen, paralleling the increased usage of cross-sectional imaging.Therefore, differentiation between early renal cell carcinoma (RCC) and benign SRM is critical to achieve proper management.Furthermore, the role of percutaneous biopsy is discussed as imaging is yet imperfect, therefore necessitating biopsy in certain circumstances to confirm the benignity of SRMs.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea.

ABSTRACT
The prevalence of small renal masses (SRM) has risen, paralleling the increased usage of cross-sectional imaging. A large proportion of these SRMs are not malignant, and do not require invasive treatment such as nephrectomy. Therefore, differentiation between early renal cell carcinoma (RCC) and benign SRM is critical to achieve proper management. This article reviews the radiological features of benign SRMs, with focus on two of the most common benign entities, angiomyolipoma and oncocytoma, in terms of their common imaging findings and differential features from RCC. Furthermore, the role of percutaneous biopsy is discussed as imaging is yet imperfect, therefore necessitating biopsy in certain circumstances to confirm the benignity of SRMs.

Show MeSH
Related in: MedlinePlus