Renal masses detected by general health checkup

Tsuboi, Narumi; Horiuchi, Kazutaka; Kimura, Go; Kondoh, Yukihiro; Yoshida, Kazuhiro; Nishimura, Taiji; Akimoto, Masao; Miyashita, Tetsuya; Subosawa, Toshiyuki

doi:10.1046/j.1442-2042.2000.00220.x

Cited by 16 publications

(11 citation statements)

References 16 publications

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“…With the aging populations and the increased use of imaging in developed countries, it is reasonable to assume that the issue of appropriate management of small renal masses will become even more important 14, 67. More radiologic examinations are performed in the elderly, with a greater chance of detection of incidental masses.…”

Section: Discussionmentioning

confidence: 99%

The natural history of incidentally detected small renal masses

Volpe

Panzarella

Rendon

et al. 2004

Cancer

479

266

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BACKGROUND The incidence of renal cell carcinoma (RCC) is increasing, largely due to the widespread use of cross‐sectional imaging. Most renal tumors are detected incidentally as small, asymptomatic masses. To study their natural history, the authors prospectively followed a series of patients with this type of lesion who were unsuited for or refused surgery. METHODS Twenty‐nine patients with 32 masses that measured < 4 cm in greatest dimension (25 solid masses and 7 complex cystic masses) were studied. The primary outcome was tumor size, which was calculated as volume over time. All patients were followed with serial abdominal imaging, and each mass had at least three follow‐up measurements. The median follow‐up was 27.9 months (range, 5.3–143.0 months). RESULTS Overall, the average growth rate did not differ statistically from zero growth (P = 0.09; 95% confidence interval, − 0.005–0.2 cm per year) and was not associated with either initial size (P = 0.28) or mass type (P = 0.41). Seven masses (22%) reached 4 cm in greatest dimension after 12–85 months of follow‐up. Eight masses (25%) doubled their volumes within 12 months. Overall, 11 masses (34%) fulfilled 1 of these 2 criteria of rapid growth. Nine tumors were removed surgically after an average of 3.1 years of follow‐up because it was believed that they were growing fast. No patient had disease progression. CONCLUSIONS Approximately one‐third of small renal masses that are presumed RCCs grow if they are managed conservatively and are followed with serial imaging. The growth rate is slow or undetectable in the majority of patients. These observations raise the possibility of a period of initial observation in selected patients, particularly the elderly or infirm. Cancer 2004;100:738–45. © 2004 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

The natural history of incidentally detected small renal masses

Volpe

Panzarella

Rendon

et al. 2004

Cancer

479

266

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“…The present study highlights the low prevalence of the disease, resulting in low detection rates. Table 2[19–25] compares these rates among different studies; the yield was slightly higher, with 0.33% solid renal tumours and 0.22% confirmed RCC. Only Terasawa et al [20] found a significant yield of RCC (2.6%) using US while screening patients with end‐stage renal disease on dialysis.…”

Section: Discussionmentioning

confidence: 99%

The utility of screening renal ultrasonography: identifying renal cell carcinoma in an elderly asymptomatic population

et al. 2005

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each patient. Screening RUS was completed by one ultrasonographer using a 3.5-MHz sector scanner. A urologist verified any abnormalities identified by RUS during consultation. Additional imaging tests were obtained selectively and intervention was recommended based on the results of the genitourinary evaluation. RESULTSFrom the screened population of 6678 patients, 817 (12.3%) renal anomalies were found, including a solid renal mass in 22 (0.32%), simple renal cysts in 627 (9.4%), hydronephrosis in 21 (0.31%), renal calculi in 121 (1.8%), or other abnormalities in 24 (0.36%). Treatment was completed for 15 renal cancers; 13 were organ-confined on pathological review. At a mean follow-up of > 55 months, 12 of the 15 patients with RCC survived. CONCLUSIONSIn this older cohort, retroperitoneal RUS was an effective tool for case-finding by detecting significant findings in an asymptomatic population. The prevalence of solid renal masses (0.32%) was higher than reported with other screening protocols. Although probably not the best method for generalized primary screening, the use of RUS may still be beneficial for 'secondary' screening in a more selected patient population.

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“…Renal cell carcinoma is also occasionally seen in adolescents and ultrasound in these patients demonstrates an isoechoic or slightly hyperechoic mass 10 . However, contrast‐enhanced CT usually shows a hypervascular rather than heterogeneous cystic and solid mixture as seen in the PNET tumour 11 .…”

Section: Discussionmentioning

confidence: 99%

Primitive neuroectodermal kidney tumour

Lee

Howard

2004

Australasian Radiology

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Renal primitive neuroectodermal tumour (PNET) is a rare malignant tumour of paediatric patients. We describe the important imaging findings, including the ultrasound, CT and MRI of a case of renal PNET in a teenager. To our knowledge, some findings have not been described previously. Some features that have been considered as characteristic are not present in our case, and it is, to our knowledge, the first documented case with such extensive tumour thrombus. We also demonstrate the importance of including PNET as a differential diagnosis because combined chemotherapy is thought to be the best first-line treatment in most cases. Histological diagnosis can be determined by a minimally invasive procedure instead of laparotomy or open biopsy.

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Renal masses detected by general health checkup

Cited by 16 publications

References 16 publications

The natural history of incidentally detected small renal masses

The natural history of incidentally detected small renal masses

The utility of screening renal ultrasonography: identifying renal cell carcinoma in an elderly asymptomatic population

Primitive neuroectodermal kidney tumour

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