Purpose: To identify size criteria for complex cystic renal masses that can distinguish renal cell carcinoma from benign cysts supplementing the Bosniak classification.
Materials And Methods: We reviewed the records of 97 patients who underwent surgery for complex cystic renal masses from January 2001 to April 2010. The pathological results were compared with the lesion sizes measured by preoperative computed tomography and other radiological features (contrast enhancement, irregularities of cyst walls and septa, and calcification) were also obtained for categorization according to the Bosniak renal cyst classification.
Results: Malignancy was significantly associated with cyst size (>2 cm), male gender, and younger patient age (<50 years). According to the Bosniak classification, there was no category I cyst, and all 8 category II cysts were benign. However, 3 of 18 (17%) category IIF cysts, 21 of 39 (54%) category III cysts, and 29 of 32 (90%) category IV cysts were malignant. All category IIF cysts were benign in patients older than 50 years of age.
Conclusion: Many complex cystic renal masses smaller than 2 cm were benign. We suggest that lesion size should be taken into account when formulating treatment plans for complex cystic renal masses.
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Bosniak Classification of Cystic Renal Masses Version 2019: Proportion of Malignancy by Class and Subclass-Systematic Review and Meta-Analysis.
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Associate Professor, University of Ottawa Department of Radiology. Clinical Epidemiology Program, Ottawa Hospital Research Institute. Room c159 Ottawa Hospital Civic Campus, 1053 Carling Ave. Ottawa, ON, K1Y 4E9.
Bosniak classification version 2019 (v2019) was a major revision to version 2005 (v2005) that defined cystic renal mass subclasses based on wall or septa features. To determine the proportion of malignancy within cystic renal masses stratified by Bosniak classification v2019 class and feature-based subclass. MEDLINE and EMBASE databases were searched on July 24, 2023 for studies published in 2019 or later that reported cystic renal masses that underwent renal-mass CT or MRI, were assessed using Bosniak v2019, and had a reference standard (histopathology indicating benignity or malignancy or ≥5-year imaging follow-up indicating benignity).
View Article and Find Full Text PDFClinical value of contrast-enhanced ultrasound combined with quantitative analysis in Bosniak ≥ II cystic renal masses.
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December 2024
Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Objective: The 2019 Bosniak classification has improved the precise and detailed quantitative evaluation criteria, making the diagnosis of cystic renal masses (CRMs) more accurate and objective. This study addresses the clinical value of quantitative analysis and aims to investigate the feasibility of combining contrast-enhanced ultrasound (CEUS) with quantitative analysis for diagnosing Bosniak ≥ II CRMs.
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Department of Urology, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing, 100191, P.R. China.
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Materials And Methods: A total of 322 patients with Bosniak II-IV cysts were included in the study from January 2010 to December 2019.
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Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, No.58 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China.
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Common incidental urological lesions on computed tomography images: What to do with renal and adrenal computed tomography incidentalomas in a primary care setting.
Aust J Gen Pract
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MBBS, PhD, FRACS (Urol), Professor, Department of Surgery, The University of Melbourne, Melbourne, Vic; Founding Director, EJ Whitten Prostate Cancer Research Centre at Epworth Healthcare, Melbourne, Vic;@Head of Unit, Department of Urology, The Royal Melbourne Hospital, Melbourne, Vic.
Article Synopsis
- The increased use of imaging techniques has led to more frequent detection of incidental findings in the kidneys and adrenal glands, often referred to as incidentalomas, which are commonly encountered by general practitioners.* -
- This review provides guidelines for managing these renal and adrenal masses, highlighting that renal lesions are seen in about 14% of CT scans and should be assessed using the Bosniak classification for cystic lesions.* -
- For renal cell carcinomas larger than 4 cm or showing symptoms, active treatment is recommended, while adrenal lesions require functional testing, with specific screening tests indicated based on clinical signs such as hypertension.*
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