Incidence of Benign Pathologic Lesions at Partial Nephrectomy for Presumed RCC Renal Masses: Japanese Dual-Center Experience with 176 Consecutive Patients

Fujii, Yasuhisa; Komai, Yoshinobu; Saito, Kazutaka; Iimura, Yasumasa; Yonese, Junji; Kawakami, Satoru; Ishikawa, Yuichi; Kumagai, Jiro; Kihara, Kazunori; Fukui, Iwao

doi:10.1016/j.urology.2008.04.054

Cited by 130 publications

(128 citation statements)

References 20 publications

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“…The incidence rates of benign pathological lesions at nephrectomy for presumed small RCC have been reported previously (5)(6)(7)(8)(19)(20)(21)(22)(23). Various incidence rates were reported, and differences were indicated based on ethnicity.…”

Section: Discussionmentioning

confidence: 92%

“…Various incidence rates were reported, and differences were indicated based on ethnicity. The reported incidences of benign pathological lesions with a tumor diameter of ≤40 mm were 17.3-23.4% in studies from Western countries (5,6,(19)(20)(21)(22)) and 7.1-15.0% in studies from Asian countries (7,8,23). Fujii et al suggested that one possible reason for the lower incidence of benign pathological findings in Asian than Western countries was the low incidence rate of oncocytoma in Asia (7), which is indistinguishable from RCC using the present imaging modalities (24).…”

Section: Discussionmentioning

confidence: 99%

“…These imaging modalities enable the clinical diagnosis of almost all tumors pre-operatively. However, the incidence rate of benign lesions among clinical cases of presumed T1a renal cell carcinoma (RCC) in surgical specimens ranges from 7.1-19.5% (5)(6)(7)(8). It is difficult to distinguish benign small renal lesions, including oncocytoma, angiomyolipoma (AML) and compromised cysts, from clinical T1a RCC by routine examinations prior to surgery (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of pre-operative imaging findings in presumed clinical T1a renal cell carcinomas

et al. 2016

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Abstract. Despite the development of recent imaging modalities, certain pathological misdiagnoses remain for surgical specimens of presumed small renal cell carcinomas (RCCs). In the present study, a retrospective analysis of benign pathological lesions diagnosed as small RCC prior to surgery was performed. In total, the cases of 196 sporadic renal tumors that was surgically treated as clinical T1a RCCs were reviewed, and the accuracy of the pathological diagnoses was calculated. The pre-operative findings for benign pathological lesions was investigated, and the lesions were observed in 13 (6.63%) of the 196 tumors. Pre-operative computed tomography images were obtained in all cases, and magnetic resonance images were available in 10 cases. The diagnostic accuracy of imaging modalities was significantly lower in the tumors with a diameter of ≤20 mm. In all cases, the possible pathological diagnosis of RCC could not be excluded even by retrospective imaging analysis. Several benign pathological lesions were found in small renal masses presumed to be clinical T1a RCC. In conclusion, there may be limitations to the pre-operative imaging for certain types of small renal mass.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of pre-operative imaging findings in presumed clinical T1a renal cell carcinomas

et al. 2016

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“…Renal angiomyolipoma usually contains significant fat and therefore, shows typical characteristics of fat on CT or MRI. The differential diagnosis of renal carcinoma is usually not difficult, but lesions with little or no fat and small tumors are difficult to discern on conventional CT, plain MRI and contrast-enhanced imaging (3)(4)(5). In addition, certain patients are allergic to the contrast material used during enhanced CT (6,7).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic utility of diffusion-weighted magnetic resonance imaging in two common renal tumors

2015

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Abstract. The aim of the present study was to evaluate the utility of diffusion-weighted magnetic resonance imaging (DWI) in the diagnosis of common renal tumors. Conventional magnetic resonance imaging and DWI were performed on 85 patients with renal lesions (54 renal carcinoma and 31 renal angiomyolipoma cases). The apparent diffusion coefficient (ADC) values in each case at b=800 sec/mm 2 were measured in the ADC maps using a statistical software package. The 54 cases of renal cell carcinoma showed a high signal intensity in the parenchyma, and the 31 renal angiomyolipoma cases showed a well-defined mixed signal intensity on DWI. The soft-tissue component showed a high signal intensity and the fat tissue showed a low signal intensity on DWI. When the b-value was set to 800 sec/mm 2 , the mean ADC was significantly lower in the renal carcinoma cases than in the renal angiomyolipoma cases. In conclusion, the measurement of ADC on DWI can reveal the structure of renal tumors, which is beneficial in diagnosing and determining the prognosis of benign and malignant renal tumors.

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“…Several studies have linked the likelihood of benign pathology with preoperative factors, such as age, 6 sex, [6][7][8][9] smoking history 6 and tumour size. [5][6][7][10][11][12][13] However, making a definitive diagnosis remains difficult.…”

Section: Introductionmentioning

confidence: 99%

Tumour location as a predictor of benign disease in the management of renal masses

Mason¹,

Abdolell²,

Rendon³

2013

CUAJ

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Objective: To investigate the association between tumour location and the proportion of benign disease in renal masses presumed to be renal cell carcinoma (RCC) preoperatively. Methods: This Institutional Review Board approved study includes 196 patients who underwent surgical treatment for renal masses <5 cm at our institution by a single surgeon between January 2002 and June 2009. Based on preoperative imaging, each mass was designated as central (touching or encroaching upon the renal collecting system and/or renal sinus) or peripheral. The association between tumour location and benign pathology was determined using univariate and multiple logistic regression, including tumour size and patient sex in the model. Results: The proportion of histologically confirmed benign disease in this series was 11.2%. The proportion of benign disease by location was 5.9% and 19.5% for central and peripheral masses, respectively. The effect of location was found to have a significant prognostic value (p = 0.0273) with an adjusted odds ratio of 3.51 (95% CI = 1.38-19.62) for the odds of a benign diagnosis in peripheral compared to central tumours. Tumour size and patient sex were not significant predictors of benign pathology (p = 0.483 and 0.191, respectively). Conclusions: Peripherally located renal masses are more likely to be benign than centrally located renal masses. This information may be used when selecting strategies for the management of renal masses presumed to be RCC.

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Incidence of Benign Pathologic Lesions at Partial Nephrectomy for Presumed RCC Renal Masses: Japanese Dual-Center Experience with 176 Consecutive Patients

Cited by 130 publications

References 20 publications

Diagnostic accuracy of pre-operative imaging findings in presumed clinical T1a renal cell carcinomas

Diagnostic accuracy of pre-operative imaging findings in presumed clinical T1a renal cell carcinomas

Diagnostic utility of diffusion-weighted magnetic resonance imaging in two common renal tumors

Tumour location as a predictor of benign disease in the management of renal masses

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