Renal oncocytoma and carcinoma: failure of differentiation with CT.

Abstract

The authors studied the hypothesis that oncocytoma and adenocarcinoma of the kidney can be differentiated with computed tomographic (CT) criteria and that differences would become more apparent as tumors enlarged. On contrast material-enhanced scans, homogeneous attenuation throughout the tumor and a central, sharply marginated, stellate area of low attenuation were considered predictors of oncocytoma. Any area of decreased attenuation in the tumor except for a stellate, central area was used as a predictor of adenocarcinoma. Among oncocytomas larger than 3 cm in diameter, 67% exhibited the criteria for oncocytoma and 33% met the criterion for adenocarcinoma; among smaller oncocytomas, the respective results were 82% and 18%. Among adenocarcinomas larger than 3 cm in diameter, 84% fulfilled the criterion for malignancy and 16% were incorrectly predicted to be oncocytomas; among smaller adenocarcinomas, the respective results were 58% and 42%. The authors conclude that the CT criteria used are poor predictors of the diagnosis of oncocytoma or adenocarcinoma regardless of tumor size.

Collision and composite tumors; radiologic and pathologic correlation

“…Results from a meta-analysis across 1711 participants and 21 studies have indicated that expression of CK7 is a major immunohistochemical marker for differentiating RCC from oncocytoma [48]. Oncocytomas enhance avidly and relatively homogeneously during the corticomedullary phase without signs of necrosis or hemorrhage, and may have a low attenuating central stellate scar on CT [59][60][61][62]. On MRI, oncocytomas are typically round well-defined masses with hypointense T1 signal and hyperintense T2 signal relative to renal cortex [63] (Fig.…”

Radiologic Imaging of Renal Masses

“…It is important to mindful that even very large lesions may be benign, and that if possible, organ sparing surgery should be a consideration. [48,49,50,51]. Familial renal oncocytomatosis is relatively uncommon, but also has been noted.…”

“…[149] Renal oncocytoma is typically described to be a hypervascular, homogeneous mass that may contain a central stellate scar on computerized tomography (CT). However, extended experience has proved these findings to be unreliable and of poor predictive value [48,49,50,51]. However, oncocytomas also appear to be quite vascular, and have a contrast uptake and drainage curve different from that of clear cell renal cell carcinoma.…”

Oncocitoma renal: Revisión de nuestra serie de 22 pacientes

“…En nuestra serie este valor es de 9,9% (2/22) si hablamos de sospecha de OR, y de 22,73% (5/22) si lo hacemos de tumor benigno. Además en RCC menores de 3 cm la posibilidad de error es mayor en los tumores de menor tamaño, encontrándose en la serie de Davidson que hasta un 42% de CCR menores de 3 cm se diagnosticaron como OR usando los criterios de homogeneidad o presencia de cicatriz central 27 .…”