Frequency of Benign Lesions in Radiologically Presumed Renal Cell Carcinoma Taking Histopathology as Gold Standard
Benign Lesions in Radiologically Presumed Renal Cell Carcinoma
DOI:
https://doi.org/10.54393/pjhs.v4i02.541Keywords:
Renal Cell Carcinoma, Nephrectomy, Histopathology, RadiologyAbstract
Renal cell carcinoma (RCC) comprises for between 90-95% of renal neoplasms in adults and about 3% of all malignancies overall. Objective: To ascertain the prevalence of benign lesions in radiologically presumed renal cell carcinoma ≤ 7 cm, using histology as the gold standard Methods: A prospective cross-sectional study was undertaken at the department of urology. A total number of 131 patients who were diagnosed possibly as RCC on CT scan. Demographic characteristics (age and gender), size of renal mass both pre-operatively and per-operatively were noted. After nephrectomy, the specimen was sent to histopathology laboratory for confirmation of diagnosis. Histopathology reports were analyzed post operatively and frequency of benign lesions in radiologically presumed RCC was determined. Results: Mean age of patients included in this study was 52.02±13.18 years. Mean size of mass pre-operatively was 4.89±1.47 cm. Mean size of mass per-operatively was 5.07±1.44 cm. There were 87 (66.41%) male and 44 (33.59%) female patients. Incidental diagnosis was made in 25 (19.08%) patients. Symptomatic predisposition was found in 107 (81.68%) patients. Partial nephrectomy was performed in 59 (45.04%) and radical nephrectomy was performed in 72 (54.96%) patients. Malignancy was diagnosed in 109 (83.21%) patients and benign lesions were diagnosed in 22 (16.79%) patients on histopathology reporting. Conclusion: The frequency of benign lesions in radiologically presumed renal cell masses in our study is 16.8%. The findings of this study may assist urologist in advising patients who have small renal masses and choosing the best course of action
References
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA: a cancer journal for clinicians. 2018 Jan; 68(1): 7-30. doi: 10.3322/caac.21442
Znaor A, Lortet-Tieulent J, Laversanne M, Jemal A, Bray F. International variations and trends in renal cell carcinoma incidence and mortality. European urology. 2015 Mar; 67(3): 519-30. doi: 10.1016/j.eururo.2014.10.002
Capitanio U and Montorsi F. Renal cancer. The Lancet. 2016 Feb; 387(10021): 894-906. doi: 10.1016/S0140-6736(15)00046-X
Novick A, Campbell S. Renal tumors. Walsh Campbell's Urology. 2003; 8(4): 2695-6
Li G, Cuilleron M, Gentil‐Perret AN, Tostain J. Characteristics of image‐detected solid renal masses: implication for optimal treatment. International journal of urology. 2004 Feb; 11(2): 63-7. doi: 10.1111/j.1442-2042.2004.00750.x
Murphy WM. Tumors of the kidney, bladder, and related urinary structures. AFIP atlas of tumor pathology series 4. 2004: 328-30. doi: 10.55418/1881041883
Remzi M, Özsoy M, Klingler HC, Susani M, Waldert M, Seitz C, et al. Are small renal tumors harmless? Analysis of histopathological features according to tumors 4 cm or less in diameter. The Journal of urology. 2006 Sep; 176(3): 896-9. doi: 10.1016/j.juro.2006.04.047
Capitanio U and Volpe A. Renal tumor biopsy: more dogma belied. European urology. 2015 Dec; 68(6): 1014-5. doi: 10.1016/j.eururo.2015.05.007
Kaushik D, Kim SP, Childs MA, Lohse CM, Costello BA, Cheville JC, et al. Overall survival and development of stage IV chronic kidney disease in patients undergoing partial and radical nephrectomy for benign renal tumors. European urology. 2013 Oct; 64(4): 600-6. doi: 10.1016/j.eururo.2012.12.023
Murphy AM, Buck AM, Benson MC, McKiernan JM. Increasing detection rate of benign renal tumors: evaluation of factors predicting for benign tumor histologic features during past two decades. Urology. 2009 Jun; 73(6): 1293-7. doi: 10.1016/j.urology.2008.12.072
Snyder ME, Bach A, Kattan MW, Raj GV, Reuter VE, Russo P. Incidence of benign lesions for clinically localized renal masses smaller than 7 cm in radiological diameter: influence of sex. The Journal of urology. 2006 Dec; 176(6): 2391-6. doi: 10.1016/j.juro.2006.08.013
Jang HA, Kim JW, Byun SS, Hong SH, Kim YJ, Park YH, et al. Oncologic and functional outcomes after partial nephrectomy versus radical nephrectomy in T1b renal cell carcinoma: a multicenter, matched case-control study in Korean patients. Cancer Research and Treatment: Official Journal of Korean Cancer Association. 2016 Apr; 48(2): 612-20. doi: 10.4143/crt.2014.122
Kutikov A, Smaldone MC, Uzzo RG. Partial versus radical nephrectomy: balancing nephrons and perioperative risk. European urology. 2013 Jan; 64(4): 607-9. doi: 10.1016/j.eururo.2013.01.020
Lee SH, Park SU, Rha KH, Choi YD, Hong SJ, Yang SC, et al. Trends in the incidence of benign pathological lesions at partial nephrectomy for presumed renal cell carcinoma in renal masses on preoperative computed tomography imaging: a single institute experience with 290 consecutive patients. International journal of urology. 2010 Jun; 17(6): 512-6. doi: 10.1111/j.1442-2042.2010.02514.x
Lane BR, Babineau D, Kattan MW, Novick AC, Gill IS, Zhou M, et al. A preoperative prognostic nomogram for solid enhancing renal tumors 7 cm or less amenable to partial nephrectomy. The Journal of urology. 2007 Aug; 178(2): 429-34. doi: 10.1016/j.juro.2007.03.106
Akdogan B, Gudeloglu A, Inci K, Gunay LM, Koni A, Ozen H. Prevalence and predictors of benign lesions in renal masses smaller than 7 cm presumed to be renal cell carcinoma. Clinical genitourinary cancer. 2012 Jun; 10(2): 121-5. doi: 10.1016/j.clgc.2012.01.005
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018 Nov; 68(6): 394-424. doi: 10.3322/caac.21492
Chow WH, Devesa SS, Warren JL, Fraumeni Jr JF. Rising incidence of renal cell cancer in the United States. Jama. 1999 May; 281(17): 1628-31. doi: 10.1001/jama.281.17.1628
Hafron J, Fogarty JD, Hoenig DM, Li M, Berkenblit R, Ghavamian R. Imaging characteristics of minimal fat renal angiomyolipoma with histologic correlations. Urology. 2005 Dec; 66(6): 1155-9. doi: 10.1016/j.urology.2005.06.119
Fujii Y, Komai Y, Saito K, Iimura Y, Yonese J, Kawakami S, et al. Incidence of benign pathologic lesions at partial nephrectomy for presumed RCC renal masses: Japanese dual-center experience with 176 consecutive patients. Urology. 2008 Sep; 72(3): 598-602. doi: 10.1016/j.urology.2008.04.054
McKiernan J, Yossepowitch O, Kattan MW, Simmons R, Motzer RJ, Reuter VE, et al. Partial nephrectomy for renal cortical tumors: pathologic findings and impact on outcome. Urology. 2002 Dec; 60(6): 1003-9. doi: 10.1016/S0090-4295(02)01967-2
Silver DA, Morash C, Brenner P, Campbell S, Russo P. Pathologic findings at the time of nephrectomy for renal mass. Annals of Surgical Oncology. 1997 Oct; 4: 570-4. doi: 10.1007/BF02305538
Murphy AM, Buck AM, Benson MC, McKiernan JM. Increasing detection rate of benign renal tumors: evaluation of factors predicting for benign tumor histologic features during past two decades. Urology. 2009 Jun; 73(6): 1293-7. doi: 10.1016/j.urology.2008.12.072
Heidenreich A and Ravery V. Preoperative imaging in renal cell cancer. World journal of urology. 2004 Oct; 22: 307-15. doi: 10.1007/s00345-004-0411-2
Kutikov A, Fossett LK, Ramchandani P, Tomaszewski JE, Siegelman ES, Banner MP, et al. Incidence of benign pathologic findings at partial nephrectomy for solitary renal mass presumed to be renal cell carcinoma on preoperative imaging. Urology. 2006 Oct; 68(4): 737-40. doi: 10.1016/j.urology.2006.04.011
Jeon HG, Lee SR, Kim KH, Oh YT, Cho NH, Rha KH, et al. Benign lesions after partial nephrectomy for presumed renal cell carcinoma in masses 4 cm or less: prevalence and predictors in Korean patients. Urology. 2010 Sep; 76(3): 574-9. doi: 10.1016/j.urology.2009.11.082
Kim SP, Thompson RH, Boorjian SA, Weight CJ, Han LC, Murad MH, et al. Comparative effectiveness for survival and renal function of partial and radical nephrectomy for localized renal tumors: a systematic review and meta-analysis. The Journal of urology. 2012 Jul; 188(1): 51-7. doi: 10.1016/j.juro.2012.03.006
Rahbar H, Bhayani S, Stifelman M, Kaouk J, Allaf M, Marshall S, et al. Evaluation of renal mass biopsy risk stratification algorithm for robotic partial nephrectomy-could a biopsy have guided management?. The Journal of urology. 2014 Nov; 192(5): 1337-42. doi: 10.1016/j.juro.2014.06.028
Halverson SJ, Kunju LP, Bhalla R, Gadzinski AJ, Alderman M, Miller DC, et al. Accuracy of determining small renal mass management with risk stratified biopsies: confirmation by final pathology. The Journal of urology. 2013 Feb; 189(2): 441-6. doi: 10.1016/j.juro.2012.09.032
Mullins JK, Kaouk JH, Bhayani S, Rogers CG, Stifelman MD, Pierorazio PM, et al. Tumor complexity predicts malignant disease for small renal masses. The Journal of urology. 2012 Dec; 188(6): 2072-6. doi: 10.1016/j.juro.2012.08.027
Osawa T, Hafez KS, Miller DC, Montgomery JS, Morgan TM, Palapattu GS, et al. Age, gender and RENAL nephrometry score do not improve the accuracy of a risk stratification algorithm based on biopsy and mass size for assigning surveillance versus treatment of renal tumors. The Journal of Urology. 2016 Mar; 195(3): 574-80. doi: 10.1016/j.juro.2015.10.137
Morrissey JJ, Mellnick VM, Luo J, Siegel MJ, Figenshau RS, Bhayani S, et al. Evaluation of urine aquaporin-1 and perilipin-2 concentrations as biomarkers to screen for renal cell carcinoma: a prospective cohort study. JAMA oncology. 2015 May; 1(2): 204-12. doi: 10.1001/jamaoncol.2015.0213
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments