Hyperechoic renal cell carcinomas: increase in detection at US.

Abstract

Recent reports have indicated that hyperechoic renal cell carcinomas (RCCAs) are more frequent among small cancers and that small cancers are being detected more frequently. To determine whether these trends have resulted in a change in the frequency of detection of hyperechoic RCCA and, in particular, in the frequency of RCCA mimicking angiomyolipomas (AMLs), the sonographic features of 90 pathologically proved RCCAs in 82 patients were retrospectively reviewed and correlated with tumor size. Tumor echogenicity was compared with that of normal renal parenchyma and classified as hypoechoic, isoechoic, slightly hyperechoic, or markedly hyperechoic. Thirty-one tumors were 3 cm in diameter or less, and 59 were larger than 3 cm. Ten (32%) of the tumors 3 cm in diameter or less were markedly hyperechoic and mimicked AMLs, whereas only one (2%) of the tumors larger than 3 cm had this appearance (P < .001). Eleven of the 90 tumors (12%) were markedly hyperechoic. Twenty-four (77%) of the small tumors were either slightly or markedly hyperechoic, compared with 19 (32%) of the larger tumors (P < .001). Because of the increased detection of small RCCAs in recent years, the number of hyperechoic cancers and the number of cancers mimicking AMLs have increased.

Differentiation of small hyperechoic renal cell carcinoma from angiomyolipoma: computer-aided tissue echo quantification.

“…In our experience as well as that of other previous investigators, AML tended to be more echogenic than RCC, 3,7,[8][9][10] and some investigators tried to differentiate these two tumors using echogenicity alone. 3,6 To our knowledge, the most systematic effort so far was made by Siegel and coworkers.…”

“…6,7 In our experience as well as that of others, AML tend to be more echogenic than RCC. 3,7,[8][9][10] Some investigators tried to differentiate these two tumors using a visual assessment of echogenicity alone without satisfactory results. 3,6 The purposes of this study were to evaluate the echogenicity of renal masses objectively and quantitatively by using CATEQ technique and to assess the value of this technique in differentiating small hyperechoic RCC from AML.…”

The diagnostic value of contrast-enhanced ultrasound in differentiating small renal carcinoma and angiomyolipoma

“…Two AMLs (9.5%) were hypoechoic on gray-scale US in this study. Forman et al (8) reported that approximately 30% of small RCCs appear as hyperechoic, which is how small benign renal masses similarly appear. In the current study, 6% of the benign renal masses were atypically iso-echoic and 29% of those masses were slightly hyperechoic.…”

Contrast-enhanced ultrasound (CEUS) of cystic and solid renal lesions: a review

“…For example, Forman showed that 77% of small RCCs showed variable echogenicity, and 32% were hyperechoic enough to mimic renal AMLs [31]. Conversely, although AMLs are typically homogenously echogenic, lipid-poor AMLs may appear isoechoic on US [32].…”