Cystic renal cell carcinoma--rare clinical finding. Radiographic variations of tumor/cyst appearance and further diagnostic work-up.

Bratisl Lek Listy

Department of Urology, University Hospital, Faculty of Medicine, Comenius University, Bratislava, Slovakia.

Published: August 2006

AI Article Synopsis

  • The study reviews cases of cystic renal cell carcinoma (CRCC) and multilocular cystic nephroma, highlighting their radiographic differences and the importance of further diagnostic work-up.
  • Between 2003 and 2005, 5 patients suspected of having CRCC were treated surgically, while 2 with multilocular cystic nephroma had ultrasound-guided biopsies.
  • Histopathological results confirmed CRCC in 4 cases and ruled out malignancy in both nephroma cases, suggesting that small CRCCs typically have favorable outcomes, allowing for less invasive treatment methods.

Article Abstract

Objectives: To review the cases of cystic renal cell carcinoma and multilocular cystic nephroma, point out the radiographic variations and define further diagnostic work-up.

Materials And Methods: Between 2003 and 2005 5 patients with suspected cystic renal cell carcinoma were treated surgically (1 pt underwent radical nephrectomy, 1 pt laparoscopic cyst decortication, 3 pts ablation), 2 patients with multilocular cystic nephroma underwent ultrasound guided biopsy.

Results: Histopathologic examination confirmed cystic renal cell carcinoma (CRCC) T1aNOM0 Fuhrman grade 1 in 3 cases, T1bN0M0 Fuhrman grade 2 in one case. One patient with suspected tumor inside the cyst wall who underwent laparoscopic cyst decortication was excluded (final histology confirmed organized hematoma in the cyst wall). Biopsy in 2 patients with multilocular cystic nephroma did not confirm the presence of malignant cells. The mean tumor size was 4.2 cm (range 3.7 to 5.5) for CRCC and 4.7 cm (range 4 to 4.5 cm) for multilocular cystic nephroma. All 4 cases of CRCC were clear cell type.

Conclusion: In conclusion according to the data described and from our study, tumor/cyst co-existence requires further surgical exploration in group 2, 3, 4. Small cystic renal cell carcinomas up to 4 cm in diameter have usually favourable pathology and prognosis, which offers the minimally invasive nephron-sparing treatment options such as excision, ablation or partial nephrectomy (Fig. 9, Ref. 18).

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