Comparison of Ultrasonography, Computerized Tomography and Angiography in Dialysis Patients with Renal Cell Carcinoma

ObjectivesTo present and discuss the epidemiological and clinical aspects, as well as therapeutic options and outcome of de novo renal cell carcinoma (RCC) of the native kidneys in a series of Chinese renal transplant recipients.Patients and MethodsA retrospective, cohort study examining all renal transplant recipients with the diagnosis of RCC of native kidney followed up in two major regional hospitals in Hong Kong between January 2000 and December 2009. Clinical data included age, gender, cause of renal failure, symptoms at presentation, duration of transplantation, immunosuppressive therapy, and history of acquired cystic kidney disease (ACKD). Laboratory, radiographic, operative, and pathology reports were used to assess the tumor extent.ResultsAmong the 1,003 renal transplant recipients recruited, 12 transplant recipients had a nephrectomy for a total of 13 RCC. The prevalence of de novo RCC was 1.3%. The mean age at diagnosis of RCC was 48.4 years, and the median time from transplantation to diagnosis was 6.1 years. ACKD was found in 6 (50%) of the patients. All patients except one were asymptomatic. pT1 disease was found in ten patients with a mean tumor size of 3.2 cm. All patients were treated successfully with radical nephrectomy. After a median follow-up of 38 months, two patients (16.7%) died. One died of sepsis, and the other died of metastatic carcinoma.ConclusionsWith increasing data showing a better prognosis if RCC is detected early by screening, it is time to consider screening all kidney transplant recipients for ACKD and RCC.

show abstract

“…[29] and Sasagawa et al . [30] reported a RCC detection rate of only 67 and 71%, respectively, with CT scan.…”

Section: Discussionmentioning

confidence: 99%

Renal cell carcinoma of native kidney in Chinese renal transplant recipients: a report of 12 cases and a review of the literature

et al. 2011

View full text Add to dashboard Cite

show abstract

“…In a recent study comparing US, CT, and angiography for detecting RCC in a selected population of dialysis patients, the accuracy of angiography was 69 % for tumors > 3 cm in diameter and 55 % for tumors < 3 cm in diameter. Angiography is accurate in depicting tumors over 3.0 cm in diameter, but it is less accurate in detecting smaller tumors [9], with a sensitivity inferior to that of both CT and US.…”

Section: Detection and Characterizationmentioning

confidence: 92%

“…Computed tomography can provide diagnosis in cases with uncertain ultrasonographic findings [9,10]. Magnetic resonance imaging is not necessary to diagnose ACKD, but it can help to further characterize an indeterminate renal mass discovered on CT; presently, it may be proposed to evaluate the extent of this disease.…”

Section: Detection and Characterizationmentioning

confidence: 99%

Is there still a place for angiography in the management of renal mass lesions?

et al. 1999

View full text Add to dashboard Cite

In recent years, the development of noninvasive imaging modalities for exploration of the kidney has markedly reduced the use of angiography in the evaluation of renal masses. Presently, it is not required in routine practice to evaluate renal masses. Ultrasound is the most efficient procedure in detecting renal tumor. It is acknowledged that arteriography has a limited diagnostic and staging value compared with CT and MRI for the assessment of renal cell carcinomas (RCC). Most urologists recommend partial nephrectomy or tumor enucleation in an effort to preserve as much as possible functioning renal tissue. In such cases a preoperative map of the renal vasculature is not needed. Information on the main renal artery(ies) and segmental renal arteries can be provided with spiral CT or dynamic MR angiography. Arteriography remains useful in exceptional situations. Interventional arteriography is becoming an important part. It is indicated by means of selective embolization for the treatment of potentially bleeding tumor (i.e. angiomyolipoma) or in emergency in cases of acute hemorrhage. Less frequently, it may be proposed as a palliative procedure for inoperable patients with huge renal tumor. Two other indications of interventional arteriography are acknowledged. Some urologists request preoperative embolization of the tumor-harboring kidney to decrease/avoid extensive blood loss during surgery and/or to facilitate surgery with huge renal tumors when the renal vessels are difficult to reach. The complications of nephron-sparing surgery (partial nephrectomy or tumor enucleation) related to bleeding or arteriovenous fistulas may be cured by arterial embolization.

show abstract

“…Insgesamt liegen nur einzelne vergleichende Studien über die bildgebende Diagnostik der Nieren unter Langzeitdialyse vor. Sasagawa et al [10] beschrieben hierbei einen Vorteil der Sonographie bei Dialysepatienten allgemein. Eine Differenzierung zwischen Patienten mit unterschiedlichen Grundkrankheiten ist jedoch auch aufgrund der geringen geschilderten Patientenzahl nicht möglich.…”

Section: Der Nieren Bei Einem Patienten Mit Terminaler Niereninsuffizunclassified

Radiologische Diagnostik der Nieren bei Dialysepatienten

et al. 1999

View full text Add to dashboard Cite

The kidneys of patients with chronic renal failure undergoing maintenance hemodialysis may show different variances or complications. Most common are secondarily acquired renal cysts, which may be found in as many as 92% of patients after 8 years of hemodialysis. Single (in 12.5% of patients) or multiple (8.3%) cysts with bleeding are common; additionally, hematuria or ruptured cysts may be found. Bleeding into cysts is more common in patients with autosomal dominant polycystic kidney disease. Due to the decreasing urinary production development of kidney stones is very uncommon, but calcifications in or around cysts can be found in 71% of patients. Kidney tumors occur 41 times more often in patients with chronic renal failure than in patients without kidney disease. We detected tumors in 4.2% of our patients on long-term dialysis. Diagnostic differentiation of the relatively slow growing and fairly late metastasizing malignant tumors from adenomas is not possible. Nevertheless, we screen our patients every 3-4 years. Computed tomography is superior to ultrasonography for this purpose, because ultrasonography lacks the necessary sensitivity in this group of patients.

show abstract

Comparison of Ultrasonography, Computerized Tomography and Angiography in Dialysis Patients with Renal Cell Carcinoma

Cited by 19 publications

References 11 publications

Renal cell carcinoma of native kidney in Chinese renal transplant recipients: a report of 12 cases and a review of the literature

Renal cell carcinoma of native kidney in Chinese renal transplant recipients: a report of 12 cases and a review of the literature

Is there still a place for angiography in the management of renal mass lesions?

Radiologische Diagnostik der Nieren bei Dialysepatienten

Contact Info

Product

Resources

About