engleski

Is the renal cyst always a cyst?

Introduction. Renal cell cancer (RCC) is the 13th most common cancer worlwide. The implementation of modern imaging modalities increase number of newly discovered RCC (3). Major goal expected from imaging technique is a correct differential diagnosis between benign and malignant renal lesions. Traditionally, ultrasound (US) was used for detection of renal pathology. Computerized tomography (CT) is, at the moment, a mostly utilized technique for such differentiation, specially in the field of cystic renal masses (4). We present three patients with renal masses completely different interpreted by US and CT. Patients and methods. From January 1th 2010 to May 31st 2013, in 185 patients from our center nephrectomy was underwent for RCC. In all patients US and CT was performed before operation. In the three patients significant disagreement between US and CT finding was found. Results. In three patients US showed focal, solid renal lesion but CT interpreted that as cystic lesion (Bosniak I-III). Since discrepancies was evident renal biopsy was performed. Biopsy revealed RCC in all three patients and nephrectomy was done. All patients had macroscopically solid RCC without cystic component. Microscopically papilar subtype of RCC was found (type I - 2 patients, type II – 1 patient). Two patient was staged as pT1a and one as pT1b. Postoperative course was uneventful in all patients. Conclusion. CT, in most cases, is the most accurate diagnostic technique for classification of renal masses. In cases where US characterized renal lesion as solid, despite CT finding of cystic lesion, kidney biopsy was recommended. This reported cases support our believe that urologist must be capable to perform and interpret US scans. Also diagnostic techniques must be complementary used.

renall cell cancer; ultrasonography; computerized tomography

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