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Corral de la Calle MÁ, Encinas de la Iglesia J, Fernández Pérez GC, Fraino A, Repollés Cobaleda M. Multiple and hereditary renal tumors: a review for radiologists. RADIOLOGIA 2024; 66:132-154. [PMID: 38614530 DOI: 10.1016/j.rxeng.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/19/2023] [Indexed: 04/15/2024]
Abstract
80% of renal carcinomas (RC) are diagnosed incidentally by imaging. 2-4% of "sporadic" multifocality and 5-8% of hereditary syndromes are accepted, probably with underestimation. Multifocality, young age, familiar history, syndromic data, and certain histologies lead to suspicion of hereditary syndrome. Each tumor must be studied individually, with a multidisciplinary evaluation of the patient. Nephron-sparing therapeutic strategies and a radioprotective diagnostic approach are recommended. Relevant data for the radiologist in major RC hereditary syndromes are presented: von-Hippel-Lindau, Chromosome-3 translocation, BRCA-associated protein-1 mutation, RC associated with succinate dehydrogenase deficiency, PTEN, hereditary papillary RC, Papillary thyroid cancer- Papillary RC, Hereditary leiomyomatosis and RC, Birt-Hogg-Dubé, Tuberous sclerosis complex, Lynch, Xp11.2 translocation/TFE3 fusion, Sickle cell trait, DICER1 mutation, Hereditary hyperparathyroidism and jaw tumor, as well as the main syndromes of Wilms tumor predisposition. The concept of "non-hereditary" familial RC and other malignant and benign entities that can present as multiple renal lesions are discussed.
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Affiliation(s)
| | | | | | - A Fraino
- Servicio de Radiodiagnóstico, Complejo Asistencial de Ávila, Ávila, Spain
| | - M Repollés Cobaleda
- Servicio de Radiodiagnóstico, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
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2
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Lian H, Pan X, Hong B, Min J, Huang F. Metastases to the kidney from primary lung cancer : clinicopathological analysis of six cases in a single center. Diagn Pathol 2023; 18:60. [PMID: 37161448 PMCID: PMC10169492 DOI: 10.1186/s13000-023-01344-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/23/2023] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVES Cancer metastasis to the kidney is a rare event. We retrospectively analyzed clinicopathologic characteristics in 6 cases of diagnosed renal metastases from primary lung cancer. We also provide clinical follow-up data and brief review of the literature. METHODS Immunohistochemistry was used to evaluate the expression of TTF-1, NapsinA, CK7, CK(AE1/AE3), P63, P40, CgA, PAX-8, GATA3 and Ki-67 in primary tumor and metastases. Additionally, the clinical characteristics, imaging features, diagnosis, and treatment were analyzed. RESULTS With the help of immunohistochemistry and combined clinical history, we found four cases were lung adenocarcinomas, one case was lung squamous cell carcinoma, and the other case was lung small cell carcinoma metastases to the kidney.The patients were all male by gender and had a mean age of 62 years, and metastasis to the left kidney were more universal. Most of the tumors histological grade originating from the lung were poorly-moderately differentiated, and the time to metastasis to the kidney was relatively short for squamous lung cancer and small cell lung cancer, while the time to metastasis for lung adenocarcinoma was related to its degree of differentiation. Overall, we found the prognosis of lung cancer patients with renal metastases were poor especially with multi-site metastases. CONCLUSIONS Distinguishing primary and secondary tumors of the kidney is essential to guide treatment and prevent unnecessary surgery, so clinical information, radiology, histological correlation of the primary tumor, and immunohistochemical findings help the pathologist determine correct diagnosis.
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Affiliation(s)
- Hui Lian
- Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xinyu Pan
- Hangzhou City Linping District Maternal and Child Care Hospital, Hangzhou, China
| | - Bo Hong
- The Department of Pathology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jie Min
- The Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Fengbo Huang
- The Department of Pathology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China.
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3
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Bashank N, Farghaly H, Hassanein S, Abdel-Tawab M, Wahman M, Mahmoud H. Rare sites of metastases in patients with differentiated thyroid carcinoma and added value of SPECT/CT over planar whole body radioactive iodine scan. Eur J Hybrid Imaging 2022; 6:34. [DOI: 10.1186/s41824-022-00155-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 10/24/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
Being aware of the unusual or rare location of thyroid metastases helps in early diagnosis and proper patient management. Rare metastases (RM) can be missed resulting in diagnostic pitfalls and delayed treatment. The use of single-photon emission computed tomography/computed tomography (SPECT/CT) imaging in the follow-up of differentiated thyroid cancer (DTC) patients provides precise anatomical localization and characterization of RM that may be missed or misinterpreted in planar whole body iodine-131 (WBI) scan. There is a lack of knowledge about dealing with such patients, the treatment they should receive, and therapy response due to the rarity of such cases. In this work, we reported these rare cases increasing awareness about them and their methods of treatment with response to therapy and evaluated the added value of SPECT/CT imaging in changing patients’ management.
Materials and methods
In this study we reviewed all patients with DTC referred to our unit either for initial radioactive iodine-131 therapy (RAIT) or under follow-up from January 2019 to January 2022. When a suspected lesion was detected in a conventional planar WBI scan whether follow-up scan or post-therapeutic scan, SPECT/CT was acquired immediately in the same session for that region. Additional imaging modalities were performed for confirmation. Response to the given treatment either disease progression (DP) or favorable response which include complete response (CR), partial regression (PR) and stable disease (SD) recorded for each patient.
Results
Two hundred and forty patients with DTC referred to our unit over a three-year period (from January 2019 to January 2022) were reviewed. Forty patients developed lung and bone distant metastases. Twenty-one patients were thought to have metastases at unusual sites. Due to incomplete data (no SPECT/CT pictures or confirmatory imaging), 6/21 patients were eliminated. We studied 15 patients with RM (9 females, 6 males) with a median age of 52 years (range 27–79). All patients received the initial RAIT after thyroidectomy in addition to other therapeutic modalities, e.g., radiotherapy (RTH), chemotherapy (CTH) or surgical tumor excision after detection of RM. Ten out of 15 patients (66.67%) showed favorable response to therapy (2 patients had CR, 6 patients had PR and 2 patients had SD), whereas only 5 patients had DP. Additional SPECT/CT changed management in 10/15 patients (66, 67%) of patients.
Conclusion
RM identification is mandatory to avoid misdiagnosis and delayed therapy. Increasing the awareness about such rare cases allows for better management. SPECT/CT could significantly impact patients' management through its precise anatomic localization and lesion characterization.
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4
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Saeed F, Osunkoya AO. Secondary Tumors of the Kidney: A Comprehensive Clinicopathologic Analysis. Adv Anat Pathol 2022; 29:241-251. [PMID: 35249993 DOI: 10.1097/pap.0000000000000338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Metastases to the kidney are rare and were historically described in autopsy series, and the incidence ranged between 2.36% and 12.6%. However, in the contemporary literature with the improvements in imaging modalities (computed tomography scan and magnetic resonance imaging) and other health care screening services, metastatic tumors to the kidney are being diagnosed more frequently in surgical specimens. The utility of needle core biopsies in the primary evaluation of renal masses has also increased the number of sampled metastases, and as a result, only limited histologic material is available for evaluation in some cases and may potentially lead to diagnostic pitfalls. In the last decade, a few large clinical series have been published. In these series, the majority of metastatic tumors to the kidney are carcinomas, with the lung being the most common primary site. A significant number of the various tumor types with metastasis to the kidney are also associated with widespread metastases to other organs, and the renal metastasis may present several years after diagnosis of the primary tumor. The majority of secondary tumors of the kidney are asymptomatic, incidentally discovered, and solitary. There should be a high index of suspicion of metastasis to the kidney in patients with an associated enlarging renal lesion with minimal to no enhancement on imaging and tumor progression of a known high-grade nonrenal malignancy. Secondary tumors of the kidney can be accurately diagnosed by correlating histopathologic features with clinical and radiographic findings and the judicious use of ancillary studies.
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Affiliation(s)
| | - Adeboye O Osunkoya
- Departments of Pathology
- Urology, Emory University School of Medicine
- Winship Cancer Institute of Emory University, Atlanta
- Department of Pathology, Veterans Affairs Medical Center, Decatur, GA
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5
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Thomas J, Ludwig DR, Ballard DH, Mellnick VM, Siegel CL, Fraum TJ. Spilling the beans: an inside scoop on the imaging of renal parenchymal disease. Abdom Radiol (NY) 2022; 47:2420-2441. [PMID: 35562564 DOI: 10.1007/s00261-022-03540-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Renal parenchymal disease is commonly encountered on imaging, and an understanding of the spectrum of pathology is vital to making correct diagnoses and recommendations for management. These conditions can be categorized based on the presence of calcifications, cysts, solid masses, patterns of enhancement, and other characteristic non-mass findings, as well as on their spatial distribution (i.e., medullary vs. cortical). Making an accurate diagnosis is often challenging, as there is overlap in the features of various diseases, and many benign entities may mimic pathology. OBJECTIVE This review broadly discusses imaging features of renal parenchymal disease and provides a systematic approach to characterize findings and appropriately guide further management.
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6
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Chen J, Qi N, Wang H, Wang Z, He Y, Zhu S. Second Primary Renal Cell Carcinoma With Nonrenal Malignancies: An Analysis of 118 Cases and a Review of Literature. Front Oncol 2021; 11:780130. [PMID: 34900734 PMCID: PMC8656157 DOI: 10.3389/fonc.2021.780130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/10/2021] [Indexed: 01/22/2023] Open
Abstract
Objectives To evaluate the nature, diagnosis, treatment and prognosis of second primary renal cell carcinoma (SPRCC). Materials and Methods We retrospectively collected data from 118 patients with SPRCC. Clinical characteristics, imaging features and treatments were analyzed and comparisons between SPRCC and renal metastases (RM) were made. Results SPRCC accounts for 11.4% of all RCC. The most common types of extrarenal malignancies included lung, colorectal, breast and gynecological cancers. The median age was 58.5 years old, and 61.0% (72/118) of the patients were male. About 5.1% of the patients presented with symptoms. The average tumor diameter was 4.4 cm (1-8.4 cm). The diagnostic specificity of enhanced computed tomography (CT) was 80.1%. When comparing with RM, more patients with stage I–II extrarenal malignancy and less patients with bilateral, multiple, and endogenic renal masses on computed tomography were found in the SPRCC group. A total of 110 SPRCC patients underwent surgery, including 48 radical nephrectomies and 62 partial nephrectomies. The median overall survival time was 117 months. Female, asymptomatic status, no distant metastasis, and surgical treatment predicted a better survival. Conclusions SPRCC are not uncommon, and it should be considered during the follow-up of patients with nonrenal malignancy. The differential diagnosis between SPRCC and RM was mainly based on imaging and puncture biopsy.
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Affiliation(s)
- Jinchao Chen
- Department of Urologic Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Nienie Qi
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Hua Wang
- Department of Urologic Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Zongping Wang
- Department of Urologic Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Yedie He
- Department of Urologic Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Shaoxing Zhu
- Department of Urologic Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
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7
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Kolla AM, Jour G, Mehnert JM. Anuric Kidney Failure in a Patient With Metastatic Melanoma. JAMA Oncol 2021; 7:1567-1568. [PMID: 34410310 DOI: 10.1001/jamaoncol.2021.3515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Avani M Kolla
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - George Jour
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Janice M Mehnert
- Laura and Isaac Perlmutter Cancer Center, NYU Grossman School of Medicine, New York, New York
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8
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Altay AY, Karatay H, Bakir B, Erdem S, Buyuk M, Ozcan F, Kilicaslan I, Ozluk Y. Diagnostic accuracy of core biopsies of renal masses: Experience in a real-life setting from a tertiary center. Ann Diagn Pathol 2021; 55:151830. [PMID: 34555597 DOI: 10.1016/j.anndiagpath.2021.151830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/17/2021] [Accepted: 09/05/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To document and analyze diagnostic accuracy of renal core biopsy (RCB), its diagnostic correlation with resection specimens, and to question the need for immunohistochemistry (IHC) in the preoperative diagnosis of renal masses. MATERIAL AND METHOD RCBs performed at a reference center between 2007 and 2017 were included. Pathological, clinical, and radiological data were obtained from medical records. RESULTS Among 302 biopsies included in this study, 274 (90.7%) were diagnostic. Two hundred sixty-six were neoplastic and 179 were of primary renal origin. The most common secondary neoplasms were hematolymphoid (n = 35) and metastatic (n = 17). Sixty-nine tumors were classified as small renal masses (SRMs) (≤4 cm in diameter) and 53 of them were malignant. Nephrectomy was performed in 58 patients. Overall diagnostic accuracy between resections and RCBs was 88.7%. IHC was performed in 160 (53%) cases. In 15 of those, a definite diagnosis could not be rendered. Renal cell origin and subtype were determined by histomorphology alone in 81 and 75 cases, respectively. Sixty primary neoplasms of renal cell origin required IHC for diagnosis. CONCLUSION RCB is a safe and highly accurate method for the diagnosis of both primary and secondary renal neoplasms. IHC is mostly required for the diagnosis of secondary tumors. Histomorphology is still the primary diagnostic tool, highly dependent on the experience of the surgical pathologist.
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Affiliation(s)
- Ali Yilmaz Altay
- Istanbul University, Istanbul Faculty of Medicine, Department of Pathology, Istanbul, Turkey.
| | - Huseyin Karatay
- Istanbul University, Istanbul Faculty of Medicine, Department of Pathology, Istanbul, Turkey
| | - Baris Bakir
- Istanbul University, Istanbul Faculty of Medicine, Department of Radiology, Istanbul, Turkey
| | - Selcuk Erdem
- Istanbul University, Istanbul Faculty of Medicine, Department of Urology, Istanbul, Turkey
| | - Melek Buyuk
- Istanbul University, Istanbul Faculty of Medicine, Department of Pathology, Istanbul, Turkey
| | - Faruk Ozcan
- Istanbul University, Istanbul Faculty of Medicine, Department of Urology, Istanbul, Turkey
| | - Isin Kilicaslan
- Istanbul University, Istanbul Faculty of Medicine, Department of Pathology, Istanbul, Turkey
| | - Yasemin Ozluk
- Istanbul University, Istanbul Faculty of Medicine, Department of Pathology, Istanbul, Turkey
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9
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Delgado J, Alonso-Riaño M, Berna-Rico E, Perez-Somarriba J, Khmaladze K, Cortes JA, Sanchez-Fructuoso A, Pascual A. Severe Acute Kidney Injury Due to Intraglomerular Melanoma: A Case Report. Am J Kidney Dis 2021; 80:147-150. [PMID: 34571065 DOI: 10.1053/j.ajkd.2021.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/09/2021] [Indexed: 11/11/2022]
Abstract
Metastatic disease in the kidney is relatively uncommon compared to other body sites. In most cases it presents as an unilateral and unifocal mass in the tubulointerstitial region. Intraglomerular metastases are even rarer, and their diagnosis is hampered by the limitation of imaging techniques to detect them. We describe the finding of intraglomerular metastases in a patient affected by a malignant melanoma considered to be in partial remission, with no evidence of melanoma progression on the previously performed computed tomography (CT) scan. This patient developed rapidly progressive kidney, failure, proteinuria and hematuria with dysmorphic red blood cells in the urine sediment. Kidney biopsy showed a marked crescentic proliferation caused by tumor cells, which even invaded the proximal convoluted tubule. Melanoma cells were also found in the lumina of the glomerular capillaries, distending their basement membranes. Our case describes the histologic and electron microscopic findings of this form of intraglomerular metastasis and reminds us of its inclusion in the differential diagnosis of rapidly progressive kidney failure.
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Affiliation(s)
- Jesus Delgado
- Department of Nephrology, Hospital Universitario Clínico San Carlos, Madrid, Spain.
| | - Marina Alonso-Riaño
- Department of Pathology, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - Emilio Berna-Rico
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Juncal Perez-Somarriba
- Department of Internal Medicine, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Khatuna Khmaladze
- Department of Nephrology, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Jose Antonio Cortes
- Department of Pathology, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | | | - Alejandro Pascual
- Department of Pathology, Hospital Universitario Clínico San Carlos, Madrid, Spain
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10
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Pilkington P, Lopci E, Adam JA, Kobe C, Goffin K, Herrmann K. FDG-PET/CT Variants and Pitfalls in Haematological Malignancies. Semin Nucl Med 2021; 51:554-571. [PMID: 34272037 DOI: 10.1053/j.semnuclmed.2021.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Hematologic malignancies represent a vast group of hematopoietic and lymphoid cancers that typically involve the blood, the bone marrow, and the lymphatic organs. Due to extensive research and well defined and standardized response criteria, the role of [18F]FDG-PET/CT is well defined in these malignancies. Never the less, the reliability of visual and quantitative interpretation of PET/CT may be impaired by several factors including inconsistent scanning protocols and image reconstruction methods. Furthermore, the uptake of [18F]FDG not only reflects tissue glucose consumption by malignant lesions, but also in other situations such as in inflammatory lesions, local and systemic infections, benign tumors, reactive thymic hyperplasia, histiocytic infiltration, among others; or following granulocyte colony stimulating factors therapy, radiation therapy, chemotherapy or surgical interventions, all of which are a potential source of false-positive or negative interpretations. Therefore it is of paramount importance for the Nuclear Medicine Physician to be familiar with, not only the normal distribution of [18F]FDG in the body, but also with the most frequent findings that may hamper a correct interpretation of the scan, which could ultimately alter the patients management. In this review, we describe these myriad of situations so the interpreting physician can be familiar with them, providing tools for their correct identification and interpretation when possible.
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Affiliation(s)
- Patrick Pilkington
- Department of Nuclear Medicine, University Hospital 12 de Octubre, Madrid, Spain.
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS-Humanitas Research Hospital, Rozzano (Milano), Italy
| | - Judit A Adam
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Carsten Kobe
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Karolien Goffin
- Department of Nuclear Medicine, University Hospital Leuven, Division of Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, Belgium
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen Germany; West German Cancer Center
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11
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Hines JJ, Eacobacci K, Goyal R. The Incidental Renal Mass- Update on Characterization and Management. Radiol Clin North Am 2021; 59:631-646. [PMID: 34053610 DOI: 10.1016/j.rcl.2021.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Renal masses are commonly encountered on cross-sectional imaging examinations performed for nonrenal indications. Although most can be dismissed as benign cysts, a subset will be either indeterminate or suspicious; in many cases, imaging cannot be used to reliably differentiate between benign and malignant masses. On-going research in defining characteristics of common renal masses on advanced imaging shows promise in offering solutions to this issue. A recent update of the Bosniak classification (used to categorize cystic renal masses) was proposed with the goals of decreasing imaging follow-up in likely benign cystic masses, and therefore avoiding unnecessary surgical resection of such masses.
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Affiliation(s)
- John J Hines
- Department of Radiology, Huntington Hospital, Northwell Health, 270 Park Avenue, Huntington, NY 11743, USA.
| | - Katherine Eacobacci
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Boulevard, Hempstead, NY 11549, USA
| | - Riya Goyal
- Department of Radiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Boulevard, Hempstead, NY 11549, USA
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12
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Poon DMC, Chan CK, Chan K, Chu WH, Kwong PWK, Lam W, Law KS, Lee EKC, Liu PL, Sze HCK, Wong JHM, Chan ESY. Consensus statements on the management of metastatic renal cell carcinoma from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology 2019. Asia Pac J Clin Oncol 2021; 17 Suppl 3:27-38. [PMID: 33860644 DOI: 10.1111/ajco.13581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND To establish a set of consensus statements for the management of metastatic renal cell carcinoma, a total of 12 urologists and clinical oncologists from two professional associations in Hong Kong formed an expert consensus panel. METHODS Through a series of meetings and using the modified Delphi method, the panelists presented recent evidence, discussed clinical experiences, and drafted consensus statements on several areas of focus regarding the management of metastatic renal cell carcinoma. Each statement was eventually voted upon by every panelist based on the practicability of recommendation. RESULTS A total of 46 consensus statements were ultimately accepted and established by panel voting. CONCLUSIONS Derived from recent evidence and expert insights, these consensus statements were aimed at providing practical guidance to optimize metastatic renal cell carcinoma management and promote a higher standard of clinical care.
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Affiliation(s)
- Darren Ming-Chun Poon
- Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong.,Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong
| | - Chun-Ki Chan
- Division of Urology, Department of Surgery, Princess Margaret Hospital, New Territories, Hong Kong
| | - Kuen Chan
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - Wing-Hong Chu
- Suite 418, Central Building, 1 Pedder Street, Central, Hong Kong
| | | | - Wayne Lam
- Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong Island, Hong Kong
| | - Ka-Suet Law
- Department of Oncology, Princess Margaret Hospital, New Territories, Hong Kong
| | - Eric Ka-Chai Lee
- Department of Clinical Oncology, Tuen Mun Hospital, New Territories, Hong Kong
| | - Pak-Ling Liu
- Department of Surgery, Caritas Medical Centre, Kowloon, Hong Kong
| | | | - Joseph Hon-Ming Wong
- Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong
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13
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Sweet DE, Ward RD, Wang Y, Tanaka H, Campbell SC, Remer EM. Infiltrative Renal Malignancies: Imaging Features, Prognostic Implications, and Mimics. Radiographics 2021; 41:487-508. [PMID: 33449838 DOI: 10.1148/rg.2021200123] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Infiltrative renal malignancies are a subset of renal masses that are morphologically characterized by a poorly defined interface with the renal parenchyma. Infiltrative renal malignancies are less common but more aggressive than more typical renal malignancies and carry an overall worse prognosis. Although an infiltrative renal process often represents a malignant neoplasm, infiltrative masses include a wide spectrum of diseases including primary renal cortical, medullary, and pelvic tumors; lymphoproliferative processes; metastases; and various infectious, inflammatory, immune-mediated, and vascular mimics. The imaging features of these masses are often nonspecific, but with the appropriate history, laboratory results, and clinical context, the radiologist can help narrow the diagnosis and guide further treatment. An invited commentary by Lee is available online.Online supplemental material is available for this article. ©RSNA, 2021.
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Affiliation(s)
- David E Sweet
- From the Imaging Institute (D.E.S., R.D.W., E.M.R.) and Glickman Urological and Kidney Institute (Y.W., H.T., S.C.C., E.M.R.), Cleveland Clinic, 9500 Euclid Ave, L10, Cleveland, OH 44195; Department of Urology, First Hospital of Jilin University, Changchun, China (Y.W.); and Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan (H.T.)
| | - Ryan D Ward
- From the Imaging Institute (D.E.S., R.D.W., E.M.R.) and Glickman Urological and Kidney Institute (Y.W., H.T., S.C.C., E.M.R.), Cleveland Clinic, 9500 Euclid Ave, L10, Cleveland, OH 44195; Department of Urology, First Hospital of Jilin University, Changchun, China (Y.W.); and Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan (H.T.)
| | - Yanbo Wang
- From the Imaging Institute (D.E.S., R.D.W., E.M.R.) and Glickman Urological and Kidney Institute (Y.W., H.T., S.C.C., E.M.R.), Cleveland Clinic, 9500 Euclid Ave, L10, Cleveland, OH 44195; Department of Urology, First Hospital of Jilin University, Changchun, China (Y.W.); and Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan (H.T.)
| | - Hajime Tanaka
- From the Imaging Institute (D.E.S., R.D.W., E.M.R.) and Glickman Urological and Kidney Institute (Y.W., H.T., S.C.C., E.M.R.), Cleveland Clinic, 9500 Euclid Ave, L10, Cleveland, OH 44195; Department of Urology, First Hospital of Jilin University, Changchun, China (Y.W.); and Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan (H.T.)
| | - Steven C Campbell
- From the Imaging Institute (D.E.S., R.D.W., E.M.R.) and Glickman Urological and Kidney Institute (Y.W., H.T., S.C.C., E.M.R.), Cleveland Clinic, 9500 Euclid Ave, L10, Cleveland, OH 44195; Department of Urology, First Hospital of Jilin University, Changchun, China (Y.W.); and Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan (H.T.)
| | - Erick M Remer
- From the Imaging Institute (D.E.S., R.D.W., E.M.R.) and Glickman Urological and Kidney Institute (Y.W., H.T., S.C.C., E.M.R.), Cleveland Clinic, 9500 Euclid Ave, L10, Cleveland, OH 44195; Department of Urology, First Hospital of Jilin University, Changchun, China (Y.W.); and Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan (H.T.)
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14
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Baniak N, Tsai H, Hirsch MS. The Differential Diagnosis of Medullary-Based Renal Masses. Arch Pathol Lab Med 2021; 145:1148-1170. [PMID: 33406251 DOI: 10.5858/arpa.2020-0464-ra] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Renal malignancies can be divided into cortical- and medullary-based tumors, the latter of which classically infiltrate the renal parenchyma by extending between nonneoplastic structures. Although high-grade cortical tumors can rarely exhibit the same growth pattern, the infiltrative morphology should elicit a differential diagnosis to be considered in each case. However, these diagnoses can be challenging to distinguish, especially on small renal biopsy samples. OBJECTIVE.— To provide an overview of the clinical, gross, and microscopic findings; genetic and molecular alterations; and immunohistochemical evaluation of medullary-based renal tumors and other tumor types with overlapping morphologies and growth patterns. DATA SOURCES.— Literature review and personal observations were used to compile the information in this review. CONCLUSIONS.— Collecting duct carcinoma is a prototypical medullary-based tumor, and although diagnostic criteria exist, it remains a diagnosis of exclusion, especially with ancillary techniques aiding the recognition of established as well as more recently described neoplasms. Other medullary-based malignancies included in the differential diagnosis include renal medullary carcinoma/renal cell carcinoma unclassified with medullary phenotype, fumarate hydratase-deficient renal cell carcinoma, and upper tract urothelial carcinoma. Moreover, other rare entities should be excluded, including metastatic carcinoma, lymphoma, and melanoma. In addition to potential prognostic differences, accurate diagnoses can have important surgical and clinical management implications.
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Affiliation(s)
- Nicholas Baniak
- From the Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Harrison Tsai
- From the Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Michelle S Hirsch
- From the Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
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15
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Seager M, Kumar S, Lim E, Munneke G, Bandula S, Walkden M. Renal cryoablation - a practical guide for interventional radiologists. Br J Radiol 2020; 94:20200854. [PMID: 32960674 DOI: 10.1259/bjr.20200854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Renal cryoablation is a treatment option for early stage renal cell carcinomas with excellent oncological outcomes and low morbidity. This review outlines the technique of renal cryoablation and provides a guide for interventional radiologists on setting up an integrated service within a renal cancer network multidisciplinary setting. Patient selection and preparation, together with the technical aspects which ensure optimal oncological outcomes and avoid collateral damage to adjacent organs are highlighted.
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Affiliation(s)
- Matthew Seager
- Interventional Oncology Service, University College Hospital, 235 Euston Road, NW1 2BU, London, United Kingdom
| | - Shankar Kumar
- Interventional Oncology Service, University College Hospital, 235 Euston Road, NW1 2BU, London, United Kingdom.,Centre for Medical Imaging, University College London, London, UK
| | - Emma Lim
- Interventional Oncology Service, University College Hospital, 235 Euston Road, NW1 2BU, London, United Kingdom
| | - Graham Munneke
- Interventional Oncology Service, University College Hospital, 235 Euston Road, NW1 2BU, London, United Kingdom
| | - Steve Bandula
- Interventional Oncology Service, University College Hospital, 235 Euston Road, NW1 2BU, London, United Kingdom.,Centre for Medical Imaging, University College London, London, UK
| | - Miles Walkden
- Interventional Oncology Service, University College Hospital, 235 Euston Road, NW1 2BU, London, United Kingdom
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16
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Agnello F, Albano D, Micci G, Di Buono G, Agrusa A, Salvaggio G, Pardo S, Sparacia G, Bartolotta TV, Midiri M, Lagalla R, Galia M. CT and MR imaging of cystic renal lesions. Insights Imaging 2020; 11:5. [PMID: 31900669 PMCID: PMC6942066 DOI: 10.1186/s13244-019-0826-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/05/2019] [Indexed: 01/28/2023] Open
Abstract
Cystic renal lesions are a common incidental finding on routinely imaging examinations. Although a benign simple cyst is usually easy to recognize, the same is not true for complex and multifocal cystic renal lesions, whose differential diagnosis includes both neoplastic and non-neoplastic conditions. In this review, we will show a series of cases in order to provide tips to identify benign cysts and differentiate them from malignant ones.
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Affiliation(s)
- Francesco Agnello
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy.
| | - Domenico Albano
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy.,Unità di Radiologia Diagnostica ed Interventistica, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Giuseppe Micci
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Giuseppe Di Buono
- Dipartimento di Discipline Chirurgiche Oncologiche e Stomatologiche, Università degli Studi di Palermo, Via Liborio Giuffrè 5, 90127, Palermo, Italy
| | - Antonino Agrusa
- Dipartimento di Discipline Chirurgiche Oncologiche e Stomatologiche, Università degli Studi di Palermo, Via Liborio Giuffrè 5, 90127, Palermo, Italy
| | - Giuseppe Salvaggio
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Salvatore Pardo
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Gianvincenzo Sparacia
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Tommaso Vincenzo Bartolotta
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy.,Dipartimento di Radiologia, Fondazione Istituto Giuseppe Giglio, Contrada Pietrapollastra, Via Picciotto, 90015, Cefalù (Palermo), Italy
| | - Massimo Midiri
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Roberto Lagalla
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Massimo Galia
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
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17
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Cazacu SM, SĂndulescu LD, Mitroi G, Neagoe DC, Streba C, Albulescu DM. Metastases to the Kidney: A Case Report and Review of the Literature. CURRENT HEALTH SCIENCES JOURNAL 2020; 46:80-89. [PMID: 32637169 PMCID: PMC7323720 DOI: 10.12865/chsj.46.01.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 01/19/2020] [Indexed: 12/16/2022]
Abstract
Renal metastases are uncommon in clinical practice, even as autopsy reports much frequent cases în disseminated tumors. Usually multiple and bilateral, they can determine many problems of differential diagnosis in case of solitary renal mass, when a primary kidney neoplasm must be excluded. Main sources are represented by the tumors of the lung, breast, digestive tract, melanomas and lymphomas, but rare cases with other etiology have been reported. Imaging can help to the diagnosis; CT scan, MRI, transabdominal ultrasound and sometimes contrast enhanced ultrasound can be useful. The treatment is individualized by the general status, by other organs involved and by the control of primary tumors; nephrectomy can be made in cases with unsure diagnosis and if primary tumor is controlled.
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Affiliation(s)
- Sergiu Marian Cazacu
- 3 Department, Internal Medicine 5 Year, University of Medicine and Pharmacy of Craiova, Research Center of Gastroenterology and Hepatology of Craiova, Romania
| | - Larisa Daniela SĂndulescu
- 3 Department, Internal Medicine 5 Year, University of Medicine and Pharmacy of Craiova, Research Center of Gastroenterology and Hepatology of Craiova, Romania
| | - George Mitroi
- Surgery Department, University of Medicine and Pharmacy of Craiova, Romania
| | - Daniela Carmen Neagoe
- 3 Department, Internal Medicine 5 Year, University of Medicine and Pharmacy of Craiova, Research Center of Gastroenterology and Hepatology of Craiova, Romania
| | - Costin Streba
- 3 Department, Pneumology discipline, University of Medicine and Pharmacy of Craiova, Romania
| | - Dana Maria Albulescu
- 2 Department, Imaging discipline, University of Medicine and Pharmacy of Craiova, Romania
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18
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Gilbert B, Cordova LZ, Eaton A. Metastatic breast cancer masquerading as a renal malignancy: A literature review and case report. Urol Case Rep 2019; 24:100859. [PMID: 31211070 PMCID: PMC6562319 DOI: 10.1016/j.eucr.2019.100859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 02/26/2019] [Indexed: 11/23/2022] Open
Abstract
Breast cancer is the most common non-cutaneous cancer affecting women. Despite this high incidence, few cases of non-disseminated breast cancer metastasizing to the kidneys have been reported. This report documents a 78-year-old female in remission for twelve years following lobular breast cancer treatment who presents with haematuria associated with a right renal pelvis lesion. Histological analysis revealed this lesion was metastatic lobular breast carcinoma. A systematic review yielded 15 documented cases of non-disseminated breast cancer metastasizing to the kidneys. This systematic review represents that most comprehensive review of the clinical presentation, pathology, prognosis and management of this rare presentation.
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Affiliation(s)
- Brent Gilbert
- Royal Hobart Hospital, Department of Urology, Hobart, Tasmania, Australia.,University of Queensland, School of Medicine, Herston, Queensland, Australia
| | | | - Anthony Eaton
- Royal Hobart Hospital, Department of Urology, Hobart, Tasmania, Australia.,Calvary Hospital, Hobart, Tasmania, Australia
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19
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Karaosmanoglu AD, Onur MR, Karcaaltincaba M, Akata D, Ozmen MN. Secondary Tumors of the Urinary System: An Imaging Conundrum. Korean J Radiol 2018; 19:742-751. [PMID: 29962880 PMCID: PMC6005933 DOI: 10.3348/kjr.2018.19.4.742] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/29/2017] [Indexed: 01/20/2023] Open
Abstract
Imaging features of metastases to the urinary system may closely mimic primary urinary tract tumors, and differential diagnosis by imaging alone may be problematic or even impossible in some cases. The main purpose of this article was to familiarize radiologists with imaging findings of metastasis to the urinary system on cross-sectional imaging, with an emphasis on abdominal and pelvic computed tomography and magnetic resonance imaging. In addition, we review the clinical importance and implications of metastases to the urinary tract and provide information on diagnostic work-ups.
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Affiliation(s)
| | - Mehmet Ruhi Onur
- Department of Radiology, Hacettepe University, School of Medicine, Ankara 06230, Turkey
| | | | - Deniz Akata
- Department of Radiology, Hacettepe University, School of Medicine, Ankara 06230, Turkey
| | - Mustafa Nasuh Ozmen
- Department of Radiology, Hacettepe University, School of Medicine, Ankara 06230, Turkey
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20
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Ballard DH, De Alba L, Migliaro M, Previgliano CH, Sangster GP. CT imaging spectrum of infiltrative renal diseases. Abdom Radiol (NY) 2017; 42:2700-2709. [PMID: 28580537 DOI: 10.1007/s00261-017-1193-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Most renal lesions replace the renal parenchyma as a focal space-occupying mass with borders distinguishing the mass from normal parenchyma. However, some renal lesions exhibit interstitial infiltration-a process that permeates the renal parenchyma by using the normal renal architecture for growth. These infiltrative lesions frequently show nonspecific patterns that lead to little or no contour deformity and have ill-defined borders on CT, making detection and diagnosis challenging. The purpose of this pictorial essay is to describe the CT imaging findings of various conditions that may manifest as infiltrative renal lesions.
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Affiliation(s)
- David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St. Louis, MO, 63110, USA
| | - Luis De Alba
- Department of Radiology, Louisiana State University Health Shreveport, 1501 Kings Hwy, Shreveport, LA, 71103, USA
| | - Matias Migliaro
- Department of Radiology, Hospital Santa Isabel de Hungria, 2854 Pedro del Castillo, Guaymallen, 5521, Mendoza, Argentina
| | - Carlos H Previgliano
- Department of Radiology, Louisiana State University Health Shreveport, 1501 Kings Hwy, Shreveport, LA, 71103, USA
| | - Guillermo P Sangster
- Department of Radiology, Louisiana State University Health Shreveport, 1501 Kings Hwy, Shreveport, LA, 71103, USA.
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21
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Purysko AS, Westphalen AC, Remer EM, Coppa CP, Leão Filho HM, Herts BR. Imaging Manifestations of Hematologic Diseases with Renal and Perinephric Involvement. Radiographics 2016; 36:1038-54. [PMID: 27257766 DOI: 10.1148/rg.2016150213] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The kidneys and perinephric tissues can be affected by a variety of hematologic disorders, which usually occur in the setting of multisystem involvement. In many of these disorders, imaging is used to evaluate the extent of disease, guide biopsy, and/or monitor disease activity and patient response to therapy. Lymphoma, leukemia, and multiple myeloma commonly manifest as multiple parenchymal or perinephric lesions. Erdheim-Chester disease and Rosai-Dorfman disease, rare forms of multisystemic histiocytosis, are often identified as perinephric and periureteral masses. Renal abnormalities depicted at imaging in patients with sickle cell disease include renal enlargement, papillary necrosis, and renal medullary carcinoma. Sickle cell disease, along with other causes of intravascular hemolysis, can also lead to hemosiderosis of the renal cortex. Thrombosis of renal veins is sometimes seen in patients with coagulation disorders but more often occurs in association with certain malignancies and nephrotic syndrome. Immunoglobulin G4-related sclerosing disease is another multisystem process that often produces focal renal lesions, seen along with involvement of more characteristic organs such as the pancreas. Perinephric lesions with calcifications should raise the possibility of secondary amyloidosis, especially in patients with a history of lymphoma and multiple myeloma. Although the imaging patterns of renal and perinephric involvement are usually not specific for a single entity, and the same entity can manifest with different or overlapping patterns, familiarity with these patterns and key clinical and histopathologic features may help to narrow the differential diagnosis and determine the next step of care. (©)RSNA, 2016.
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Affiliation(s)
- Andrei S Purysko
- From the Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Mail Code JB-3, Cleveland, OH 44195 (A.S.P., E.M.R., C.P.C., B.R.H.); Abdominal Imaging Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, Calif (A.C.W.); and Department of Radiology, Hospital do Coração and Teleimagem, São Paulo, Brazil (H.M.L.F.)
| | - Antonio C Westphalen
- From the Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Mail Code JB-3, Cleveland, OH 44195 (A.S.P., E.M.R., C.P.C., B.R.H.); Abdominal Imaging Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, Calif (A.C.W.); and Department of Radiology, Hospital do Coração and Teleimagem, São Paulo, Brazil (H.M.L.F.)
| | - Erick M Remer
- From the Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Mail Code JB-3, Cleveland, OH 44195 (A.S.P., E.M.R., C.P.C., B.R.H.); Abdominal Imaging Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, Calif (A.C.W.); and Department of Radiology, Hospital do Coração and Teleimagem, São Paulo, Brazil (H.M.L.F.)
| | - Christopher P Coppa
- From the Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Mail Code JB-3, Cleveland, OH 44195 (A.S.P., E.M.R., C.P.C., B.R.H.); Abdominal Imaging Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, Calif (A.C.W.); and Department of Radiology, Hospital do Coração and Teleimagem, São Paulo, Brazil (H.M.L.F.)
| | - Hilton M Leão Filho
- From the Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Mail Code JB-3, Cleveland, OH 44195 (A.S.P., E.M.R., C.P.C., B.R.H.); Abdominal Imaging Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, Calif (A.C.W.); and Department of Radiology, Hospital do Coração and Teleimagem, São Paulo, Brazil (H.M.L.F.)
| | - Brian R Herts
- From the Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Mail Code JB-3, Cleveland, OH 44195 (A.S.P., E.M.R., C.P.C., B.R.H.); Abdominal Imaging Section, Department of Radiology and Biomedical Imaging, University of California, San Francisco, Calif (A.C.W.); and Department of Radiology, Hospital do Coração and Teleimagem, São Paulo, Brazil (H.M.L.F.)
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22
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Zhou C, Urbauer DL, Fellman BM, Tamboli P, Zhang M, Matin SF, Wood CG, Karam JA. Metastases to the kidney: a comprehensive analysis of 151 patients from a tertiary referral centre. BJU Int 2015; 117:775-82. [PMID: 26053895 DOI: 10.1111/bju.13194] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To describe the presentation, treatment and outcomes of patients with metastatic tumours to the kidney treated at a tertiary referral centre. PATIENTS AND METHODS We retrospectively identified 151 patients diagnosed with a primary non-renal malignancy with renal metastasis. Clinical, radiographic and pathological characteristics were assessed. Overall survival (OS) was calculated using Kaplan-Meier methods. RESULTS The median patient age was 56.7 years. The most common presenting symptoms were flank pain (30%), haematuria (16%) and weight loss (12%). Most primary cancers were carcinomas (80.8%). The most common primary tumour sites were lung (43.7%), colorectal (10.6%), head and neck (6%), breast (5.3%), soft tissue (5.3%) and thyroid (5.3%). Renal metastases were typically solitary (77.5%). Concordance between radiologist and clinician imaging assessment was 54.0%. Three ablations and 48 nephrectomies were performed. For non-surgical patients, renal metastasis diagnosis was made with fine-needle aspiration or biopsy. The median OS from primary tumour diagnosis was 3.08 years and the median OS from time of metastatic diagnosis was 1.13 years. For patients treated with surgery, median OS from primary tumour diagnosis was 4.81 years, and OS from metastatic diagnosis was 2.24 years. CONCLUSIONS Metastases to the kidney are a rare entity. Survival appears to be longer in patients who are candidates for and are treated with surgery. Surgical intervention in carefully selected patients with oligometastatic disease and good performance status should be considered. A multidisciplinary approach with input from urologists, oncologists, radiologists and pathologists is needed to achieve the optimum outcomes for this specific patient population.
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Affiliation(s)
- Cathy Zhou
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Diana L Urbauer
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bryan M Fellman
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Pheroze Tamboli
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Miao Zhang
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Surena F Matin
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Christopher G Wood
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jose A Karam
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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23
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Mazouz A, Amaadour L, souaf I, El Fatemi H, Amarti A, Erraisse MA, Oubelkacem E, Bouhafa T, Tahiri Y, Tazi MF, Mellas S, Arifi S, Mellas N. Synchronous malignant renal mass in patient with a Lung cancer: case report and literature review. Pan Afr Med J 2015; 20:22. [PMID: 26015842 PMCID: PMC4432812 DOI: 10.11604/pamj.2015.20.22.5541] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 12/12/2014] [Indexed: 11/16/2022] Open
Abstract
The finding on imaging (computed tomography scan or magnetic resonance imaging) of synchronous malignant renal mass in patient with an active nonrenal malignancy without renal specific symptoms is not frequent and diagnostic evaluation can be challenging. We describe a 54-year-old Moroccan male former chronic smoker who presented to our hospital with dry cough and impairment of the performance status. The imaging found a tumor mass in the left upper lobe of the lung associated to mediastinal lymph node and a scanno-guided biopsy of this tumor showed a non small cell lung cancer. The radiological staging revealed a solitary renal mass in the right kidney. The patient received firstly two cycles of a lung cancer chemotherapy with a partial response in the lung and a stability of the renal mass. Consequently, he underwent a scanno-guided biopsy of this mass which confirmed a synchronous clear cell renal carcinoma. The patient got chemo radiotherapy for the lung cancer and then after that he got a partial nephrectomy. He is still under a good control with more than 2 years after the initial diagnosis.
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Affiliation(s)
- Aicha Mazouz
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Lamiae Amaadour
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Ihsane souaf
- Department of Pathology, Hassan II University Hospital, Fez, Morocco
| | - Hinde El Fatemi
- Department of Pathology, Hassan II University Hospital, Fez, Morocco
| | - Afaf Amarti
- Department of Pathology, Hassan II University Hospital, Fez, Morocco
| | | | | | - Touria Bouhafa
- Department of Radiotherapy, Hassan II University Hospital, Fez, Morocco
| | - Yassir Tahiri
- Department of Urology, Hassan II University Hospital, Fez, Morocco
| | | | - Soufiane Mellas
- Department of Urology, Hassan II University Hospital, Fez, Morocco
| | - Samia Arifi
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Nawfel Mellas
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
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24
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Abstract
Papillary architecture is one of the most common morphological patterns in renal cell neoplasms. Many renal cell neoplasms can also exhibit, diffusely or focally, papillary growth pattern. This article reviews all the renal cell neoplasms with papillary or pseudopapillary architecture, with an emphasis on recently described new histological types. New insights into the "old" entities, including their immunohistochemical and genetic features, will also be discussed.
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Affiliation(s)
- Fang-Ming Deng
- Department of Pathology, New York University Langone Medical Center, New York, New York; Department of Urology, New York University Langone Medical Center, New York, New York
| | - Max X Kong
- Department of Pathology, New York University Langone Medical Center, New York, New York; Department of Urology, New York University Langone Medical Center, New York, New York
| | - Ming Zhou
- Department of Pathology, New York University Langone Medical Center, New York, New York; Department of Urology, New York University Langone Medical Center, New York, New York.
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25
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Metastatic papillary thyroid carcinoma to the kidney: report of two cases mimicking primary renal cell carcinoma and review of the literature. Pathology 2014; 45:89-93. [PMID: 23255036 DOI: 10.1097/pat.0b013e32835b5dcc] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Ter Avest MJ, Schook RM, Koudstaal LG, Grünberg K, Paul MA, Smit EF, Postmus PE. Benefit of a second opinion for lung cancer: no metastasis to the kidney but a synchronous primary renal neoplasm. Case Rep Oncol 2014; 7:122-5. [PMID: 24707259 PMCID: PMC3975755 DOI: 10.1159/000359996] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background The finding of a renal mass on imaging is suggestive of metastatic non-small cell lung cancer in the presence of a lung tumor but can also have another origin. Case Report We describe the case of a patient diagnosed with stage IV lung cancer based on a renal metastasis. A second opinion including review of histopathological data and additional imaging followed by lung surgery and cryoablation of the kidney lesion revealed two tumors of different origins, non-small cell lung cancer and a renal cell carcinoma. Discussion The presence of a renal mass diagnosed on a CT scan in a patient with lung cancer is not always synonymous with metastatic disease. Confirmation of diagnosis by tissue sampling is mandatory, especially if a synchronous primary tumor is possible.
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Affiliation(s)
- Marleen J Ter Avest
- Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, The Netherlands
| | - Romane M Schook
- Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, The Netherlands
| | - Lyan G Koudstaal
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Katrien Grünberg
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Marinus A Paul
- Department of Cardiothoracic Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Egbert F Smit
- Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, The Netherlands
| | - Pieter E Postmus
- Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, The Netherlands
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Tsivian M, Rampersaud EN, del Pilar Laguna Pes M, Joniau S, Leveillee RJ, Shingleton WB, Aron M, Kim CY, DeMarzo AM, Desai MM, Meler JD, Donovan JF, Klingler HC, Sopko DR, Madden JF, Marberger M, Ferrandino MN, Polascik TJ. Small renal mass biopsy - how, what and when: report from an international consensus panel. BJU Int 2014; 113:854-63. [DOI: 10.1111/bju.12470] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Matvey Tsivian
- Division of Urology; Department of Surgery; Duke University Medical Center; Durham NC USA
| | - Edward N. Rampersaud
- Division of Urology; Department of Surgery; Duke University Medical Center; Durham NC USA
| | | | | | | | - William B. Shingleton
- Section of Urology; Department of Surgery; Georgia Health Sciences University; Augusta GA USA
| | - Monish Aron
- Department of Urology; University of Southern California; Los Angeles CA USA
| | - Charles Y. Kim
- Department of Radiology; Duke University Medical Center; Durham NC USA
| | - Angelo M. DeMarzo
- Department of Pathology; Johns Hopkins University Medical Center; Baltimore MD USA
| | - Mihir M. Desai
- Department of Urology; University of Southern California; Los Angeles CA USA
| | - James D. Meler
- Department of Radiology; Baylor University Medical Center; Dallas TX USA
| | - James F. Donovan
- Division of Urology; Department of Surgery; University of Cincinnati; Cincinnati OH USA
| | | | - David R. Sopko
- Department of Radiology; Duke University Medical Center; Durham NC USA
| | - John F. Madden
- Department of Pathology; Duke University Medical Center; Durham NC USA
| | | | - Michael N. Ferrandino
- Division of Urology; Department of Surgery; Duke University Medical Center; Durham NC USA
| | - Thomas J. Polascik
- Division of Urology; Department of Surgery; Duke University Medical Center; Durham NC USA
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Aras M, Dede F, Ones T, Inanır S, Erdil TY, Turoğlu HT. Is The Value of FDG PET/CT In Evaluating Renal Metastasis Underestimated? A Case Report And Review of The Literature. Mol Imaging Radionucl Ther 2013; 22:109-12. [PMID: 24416629 PMCID: PMC3888013 DOI: 10.4274/mirt.130] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Accepted: 01/24/2012] [Indexed: 12/28/2022] Open
Abstract
UNLABELLED Contrast-enhanced CT or MRI are used as a gold standard imaging modalities in the detection and characterization of renal masses. On the other hand, the role of FDG PET/CT in evaluating primary or metastatic cancers of the kidney is limited due to the excretion of FDG through urinary tract. We reported the FDG PET/CT of a lung cancer patient with multiple metastases in both kidneys which were missed in previous PET/CT, and underestimated on sequential diagnostic abdominal CT study. CONFLICT OF INTEREST None declared.
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Affiliation(s)
- Mustafa Aras
- Marmara University School of Medicine, Department of Nuclear Medicine, Istanbul, Turkey
| | - Fuat Dede
- Marmara University School of Medicine, Department of Nuclear Medicine, Istanbul, Turkey
| | - Tunç Ones
- Marmara University School of Medicine, Department of Nuclear Medicine, Istanbul, Turkey
| | - Sabahat Inanır
- Marmara University School of Medicine, Department of Nuclear Medicine, Istanbul, Turkey
| | - Tanju Yusuf Erdil
- Marmara University School of Medicine, Department of Nuclear Medicine, Istanbul, Turkey
| | - Halil Turgut Turoğlu
- Marmara University School of Medicine, Department of Nuclear Medicine, Istanbul, Turkey
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