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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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23-year-old woman with small juxtaglomerular cell tumor and underlying hypertension.A. Power Doppler ultrasound demonstrates renal mass (arrow) with poor vascularity. B, C. Axial corticomedullary (B) and nephrographic (C) CT shows same mass (arrow) without prominent enhancement in right kidney. At surgery, mass was confirmed as juxtaglomerular cell tumor.
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Figure 7: 23-year-old woman with small juxtaglomerular cell tumor and underlying hypertension.A. Power Doppler ultrasound demonstrates renal mass (arrow) with poor vascularity. B, C. Axial corticomedullary (B) and nephrographic (C) CT shows same mass (arrow) without prominent enhancement in right kidney. At surgery, mass was confirmed as juxtaglomerular cell tumor.

Mentions: Juxtaglomerular cell (JGC) tumor, also known as reninoma, is an extremely rare, benign renal tumor of myoendocrine cell origin (79). Almost all cases occur in the second and third decades with 2:1 female preponderance. With regard to diagnosing JGC tumor, the clinically setting is of utmost importance. A patient with JGC tumor typically manifests with a triad of poorly controlled hypertension, hypokalemia, and high plasma renin activity (80). At imaging, JGC tumors classically appear as a unilateral, well-marginated, cortical tumor smaller than 3 cm (81). JGC tumors usually appear hypovascular with delayed enhancement on contrast-enhanced CT and MRI despite its profuse vascularity (Fig. 7). This is speculated to be due to renin-induced vasoconstriction (82).


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)

23-year-old woman with small juxtaglomerular cell tumor and underlying hypertension.A. Power Doppler ultrasound demonstrates renal mass (arrow) with poor vascularity. B, C. Axial corticomedullary (B) and nephrographic (C) CT shows same mass (arrow) without prominent enhancement in right kidney. At surgery, mass was confirmed as juxtaglomerular cell tumor.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 7: 23-year-old woman with small juxtaglomerular cell tumor and underlying hypertension.A. Power Doppler ultrasound demonstrates renal mass (arrow) with poor vascularity. B, C. Axial corticomedullary (B) and nephrographic (C) CT shows same mass (arrow) without prominent enhancement in right kidney. At surgery, mass was confirmed as juxtaglomerular cell tumor.
Mentions: Juxtaglomerular cell (JGC) tumor, also known as reninoma, is an extremely rare, benign renal tumor of myoendocrine cell origin (79). Almost all cases occur in the second and third decades with 2:1 female preponderance. With regard to diagnosing JGC tumor, the clinically setting is of utmost importance. A patient with JGC tumor typically manifests with a triad of poorly controlled hypertension, hypokalemia, and high plasma renin activity (80). At imaging, JGC tumors classically appear as a unilateral, well-marginated, cortical tumor smaller than 3 cm (81). JGC tumors usually appear hypovascular with delayed enhancement on contrast-enhanced CT and MRI despite its profuse vascularity (Fig. 7). This is speculated to be due to renin-induced vasoconstriction (82).

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