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- Title
Large Renal Tumor with Benign Evolution in a CKD Patient – Could It Be an Oncocytoma?
- Authors
Chirilă, C. N.; Gliga, M. L.; Martha, Orsolya; Chirilă, P. M.; Horvath-Hegyi, T. B.
- Abstract
Introduction and Objectives. Renal oncocytomas are benign tumors consisting of oncocytes with a peak incidence at 55 years of age, often asymptomatic, found accidentally on ultrasound (US) examination. They appear as solid, solitary, well-marginated, capsule-less, fairly homogeneous renal cortical masses, with regular shape, relatively isoechoic or slightly hyperechoic than the adjacent renal parenchyma. Our aim was to depict the difficulties of imaging investigations in chronic kidney disease (CKD) patients by characterizing the clinical and US patterns in a patient with a renal mass suspected to be malignant, but with benign evolution. Materials and Methods. A 61-year-old woman was examined in the Department of Nephrology of the Mures County Hospital in a period of six years, starting from 2012. She was followed-up for CKD stage IV. We performed complete abdominal US examination and we described the US characteristics of the left kidney mass. US examinations were performed with Esaote MyLab50 X-Vision and with Philips HD11 devices using a 3.5 MHz abdominal transducer. Results. US grey-scale features were not enough to differentiate this lesion from renal carcinoma. Color Doppler US revealed an intense vascularization and surgical treatment was indicated. Because of the lack of compliance and severe comorbidities, surgery was postponed and the patient was followed up every six months in order to assess the progression of CKD and the renal mass. There was no significant increase in the size of the tumor and the patient remained asymptomatic. In 2018 chronic hemodialysis was initiated. After that, a contrast enhanced CT scan could be performed. The tumour measured aproximately the same size as in 2012 and 2016 and had a central scar that was suggestive for benignity. Conclusions. In CKD patients in which contrast agents are contraindicated, the complete description of grey-scale and Doppler US characteristics of renal masses are mandatory in order to assess the best prognosis and the evolution. We strongly recommend US examination as the most reliable imaging modality for the diagnosis and monitoring of this category of patients.
- Subjects
BENIGN tumors; CHRONIC kidney failure; BIOLOGICAL evolution
- Publication
Romanian Journal of Urology, 2018, Vol 17, Issue 3, p37
- ISSN
1223-0650
- Publication type
Article