The role of imaging in the management of renal masses

Tsili, Athina C.; Andriotis, Efthimios; Gkeli, Myrsini; Krokidis, Μiltiadis; Stasinopoulou, Myrsini; Varkarakis, Ioannis; Moulopoulos, Lia A.

doi:10.1016/j.ejrad.2021.109777

Cited by 25 publications

(13 citation statements)

References 179 publications

(358 reference statements)

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“…Use of these phases is instrumental in characterizing cystic masses and can be predictive of an RCC histologic subtype. An arterial phase can provide helpful preoperative information regarding hilar anatomy, but can also highlight a potential tumor-related AVM [ 15 ]. Excretory-phase imaging highlights the tumor's relationship to the collecting system, which will also assist in surgical planning, particularly when attempting a nephron-sparing approach.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Crisis Averted: Clinical T1b Renal Mass with Concurrent Arteriovenous Malformation and Renal Vein Thrombus

Zekan

Wasef

Werner

et al. 2022

Case Reports in Urology

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Arteriovenous malformations (AVMs) secondary to renal-cell carcinoma (RCC) are well-described in the literature. Independently, renal vein and inferior vena cava tumor thrombi can be detected in locally-advanced RCC. A 67-year-old gentleman presented with a cT1b renal mass detected on workup for elevated creatinine. Multiphase CT imaging obtained for partial nephrectomy surgical-planning revealed an initially-missed renal cortical AVM. This drastically changed the plan for intervention, including use of an open approach with AVM embolization by interventional radiology prior and avoidance of a nephron-sparing approach. Final pathology confirmed the AVM and a subclinical renal vein thrombus masked by arterial flow on CT imaging, making this the first concurrent case described in the literature. Herein, we describe avoidance of catastrophic intraoperative hemorrhage by careful review of preoperative imaging and provide a literature review of imaging modalities for both renal surgical-planning and detection of tumor thrombi in RCC.

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Section: Discussion/conclusionmentioning

confidence: 99%

Crisis Averted: Clinical T1b Renal Mass with Concurrent Arteriovenous Malformation and Renal Vein Thrombus

Zekan

Wasef

Werner

et al. 2022

Case Reports in Urology

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“…In the correct radiological disease management, multimodality imaging, including ultrasound (US), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI), should also be preferred concerning the different phases of DTs approaches [ 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 ]. In fact, during radiologist work-up, different moments may be considered: detection and characterization, adjacent structures involvement assessment, treatment response evaluation and surveillance [ 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 ]. During each of these moments, the different techniques can be associated with and/or follow each other.…”

Section: Imagingmentioning

confidence: 99%

Multimodality Imaging Assessment of Desmoid Tumors: The Great Mime in the Era of Multidisciplinary Teams

Simonetti

Bruno

Fusco

et al. 2022

JPM

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Desmoid tumors (DTs), also known as desmoid fibromatosis or aggressive fibromatosis, are rare, locally invasive, non-metastatic soft tissue tumors. Although histological results represent the gold standard diagnosis, imaging represents the fundamental tool for the diagnosis of these tumors. Although histological analysis represents the gold standard for diagnosis, imaging represents the fundamental tool for the diagnosis of these tumors. DTs represent a challenge for the radiologist, being able to mimic different pathological conditions. A proper diagnosis is required to establish an adequate therapeutic approach. Multimodality imaging, including ultrasound (US), computed tomography (CT) and Magnetic Resonance Imaging (MRI), should be preferred. Different imaging techniques can also guide minimally invasive treatments and monitor their effectiveness. The purpose of this review is to describe the state-of-the-art multidisciplinary imaging of DTs; and its role in patient management.

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“…However, in the last decade, the refinements in systemic therapies of mRCC, with the introduction of the antiangiogenic tyrosine kinase inhibitors (TKIs) and the immune checkpoint inhibitors (CKIs), have prolonged the overall survival (OS) [ 4 ]. Due to the more and more widespread use of ultrasound imaging for the evaluation of a variety of nonspecific symptoms, more than 50% of renal masses are detected incidentally [ 5 ]. As a consequence, paraneoplastic syndromes are the first sign in 20% of cases.…”

Section: Introductionmentioning

confidence: 99%

Metastatic Clear Cell Renal Cell Carcinoma: The Great Pretender and the Great Dilemma

et al. 2021

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Metastatic renal cell carcinoma (mRCC) may present with a wide range of clinical pictures. Reportedly, paraneoplastic syndromes are the first sign in 20% of cases and only 15% of cases show the classic triad (flank pain, gross hematuria, and palpable abdominal mass) at presentation. The remaining cases present with signs and symptoms related to the site of distant metastases. These data may explain the reason why about 20-30% of patients are metastatic at presentation. We report the case of a 63-year-old woman who came to our attention for lower back pain. After imaging studies, we detected a left kidney mass of 86 × 61 × 79 mm, multiple right pulmonary nodules and six bone lesions. She underwent left radical nephrectomy. After 1 month, she developed signs of spinal cord compression with neurological deficits and she underwent emergency spinal decompression. In order to allow complete motor recovery, the subsequent stereotactic body radiation therapy was not performed, and she is currently taking combination immunotherapy regimens. Management of mRCC is in a continuous evolution due to availability of new target therapies and the possibility of a multimodal approach with surgical, focal and radiotherapy treatments. However, the ideal treatment algorithm is yet to come. This is why mRCC diagnosis and management are still challenging for the clinicians.

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The role of imaging in the management of renal masses

Cited by 25 publications

References 179 publications

Crisis Averted: Clinical T1b Renal Mass with Concurrent Arteriovenous Malformation and Renal Vein Thrombus

Crisis Averted: Clinical T1b Renal Mass with Concurrent Arteriovenous Malformation and Renal Vein Thrombus

Multimodality Imaging Assessment of Desmoid Tumors: The Great Mime in the Era of Multidisciplinary Teams

Metastatic Clear Cell Renal Cell Carcinoma: The Great Pretender and the Great Dilemma

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