Renal neoplasms in patients with renal cystic diseases

Reichard, Elizabeth; Roubidoux, Marilyn A.; Dunnick, N. Reed

doi:10.1007/s002619900334

Cited by 18 publications

(4 citation statements)

References 58 publications

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“…The association of RCC and ADPKD is controversial (11, 12, 22) and there are no studies that definitively show an increased incidence. Renal cancer was seen in two patients, or 6.6% of the population, which is a higher incidence than the general population.…”

Section: Discussionmentioning

confidence: 99%

“…ADPKD is a multi‐organ disease (6), with the involvement of the cardiovascular system (hypertension, valve abnormalities, intracranial aneurysms) and gastrointestinal system (liver cysts, pancreatic cysts, and colon diverticula) (2, 7–10). The association of renal cell carcinoma with ADPKD has been described since 1934 (11); however, the incidence of cancer in ADPKD has not been elucidated (12).…”

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confidence: 99%

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Autosomal dominant polycystic kidney disease: MR imaging evaluation using current techniques

Mosetti

Leonardou

Motohara

et al. 2003

Magnetic Resonance Imaging

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Purpose: To determine the MR imaging findings of autosomal dominant polycystic kidney disease using current imaging techniques. Materials and Methods:We reviewed our five-year experience with MR imaging of autosomal dominant polycystic kidney disease (ADPKD) to determine the spectrum of appearance of kidney disease, the occurrence of cysts in other abdominal organs, the size and number of cysts in the kidneys and other organs, and the association with other benign or malignant disease. Thirty patients (17 men and 13 women, age range 30 to 88 years old) with ADPKD were included in this study. All patients were examined by MR imaging including T2-weighted single-shot echo-train spinecho and pre-and post-gadolinium chelate spoiled gradient-echo imaging.Results: All kidneys were involved with multiple, varying sized cysts scattered throughout the parenchyma. Giant renal cysts (Ͼ8 cm) were associated with pain in the only two patients who possessed them. Hemorrhage in renal cysts was observed in all kidneys with a heterogeneous pattern of involvement on non-contrast T1-and T2-weighted images, reflecting hemorrhage of varying age. The mean kidney size for the right kidney was 17.4 cm in length, 10.3 cm in transverse, and 9.4 cm in antero-posterior diameter (AP); and for the left kidney, 15.9 cm in the length, 9.3 cm in the transverse, and 9.3 cm in AP diameter. Other organs involved included the liver (22 patients), the pancreas (three patients), with two of the above-mentioned patients having both liver and pancreas cysts, and the spleen (one patient) who had both liver and splenic cysts. Massive liver involvement with large cysts was associated with abdominal pain. Malignant disease was present in five patients, including two patients with renal cell carcinoma, one with bladder cancer, one with lung cancer, and one patient with anal adenocarcinoma. Comparison of preand post-contrast T1-weighted images was essential to detect renal cancer. Conclusion:All kidneys in patients with ADPKD had extensive, varying-sized cysts and in all cases some cysts showed evidence of hemorrhage. The liver was the second most common organ to be involved with cystic disease, in 73% of patients. Large cysts in the kidneys and liver were associated with abdominal pain.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Autosomal dominant polycystic kidney disease: MR imaging evaluation using current techniques

Mosetti

Leonardou

Motohara

et al. 2003

Magnetic Resonance Imaging

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“…Cysts are frequently complicated (50%) due to haemorrhage. The etiology of which may be benign, but it may also be due to a carcinoma of the cyst wall [78,79]. Helical CT improves the characterization of hyperdense cysts and the detection of small RCCs in areas not involved by cysts.…”

Section: Renal Cystic Diseases Associated With Renal Neoplasmsmentioning

confidence: 99%

“…There is also an increased occurrence of bilateral RCCs. Differentiation of angiomyolipomas from RCCs in small lesions with minimal amount of fat is best performed with HCT; however, fat may be obscured by haemorrhage [79,80].…”

Section: Renal Cystic Diseases Associated With Renal Neoplasmsmentioning

confidence: 99%

Helical CT of the urinary organs

Ruppert-Kohlmayr

2002

Eur Radiol

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Despite of the diagnostic potential of conventional CT (CCT), limitations being inherent in this technology reduce its diagnostic confidence and limit clinical CT applications as 3D imaging. Helical CT (HCT) has far overcome the limitations of CCT and has become the standard CT technology. After a short overview on the technique of HCT and its advantages over CCT, the impact of HCT on the detection of disorders of the urinary organs is discussed. Due to the high quality of 3D reconstructions, vessels are visualized free of artefacts resulting in a dramatic improvement and acceptance of CT angiography, which has become a clinically important examination in the evaluation of obstructive renal artery disease. Fast HCT provides a precise assessment of the three phases of the nephrogram and it is a prerequisite for an improved depiction of abnormal vascular perfusion and impaired tubule transit of contrast material. Helical CT enables an improved characterization of cystic mass lesions reducing the diagnosis of indeterminate masses and thus facilitating a better therapeutic management. The diagnosis of renal cell carcinomas (RCC) has improved due to an increased sensitivity in detecting small RCCs, and an increased specificity in the diagnosis of neoplastic lesions. Improved staging of RCCs is the result of accurate assessment of venous tumour extension. When planning nephron-sparing surgery 3D display of the renal tumour helps to determine the resectability of the mass depicting its relation to major renal vessels and the renal collecting system. In the evaluation of renal trauma HCT provides shorter scanning time and thus fewer artefacts in the examination of traumatized patients who cannot cooperate adequately. Three-dimensional postprocessing modalities allow the assessment of the renal vascular pedicel by CT angiography and improve the demonstration of complex lacerations of the renal parenchyma. In the evaluation of the upper urinary tract unenhanced HCT has become the imaging method of choice in the diagnosis and differential diagnosis of acute flank pain since it is highly sensitive and specific in detecting calculus disease. Unenhanced HCT may furthermore demonstrate causes of flank pain unrelated to urolithiasis. Gapless volume scanning and improved resolution in the z-axis during the excretory phase enables improved visualization of the renal collecting systems and ureters, resulting in a better demonstration of intraluminal and extraluminal pathology.

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