scholarly journals The clinical presentation, imaging features and differential diagnoses of congenital Wilms tumour

2019 ◽  
Vol 12 (5) ◽  
pp. e228651
Author(s):  
Fidel Rampersad ◽  
Jason Diljohn ◽  
Cristal Goetz
Keyword(s):  
Renal Mass ◽  
Surgical Excision ◽  
Postnatal Period ◽  
Differential Diagnoses ◽  
Imaging Features ◽  
Renal Masses ◽  
Antenatal Ultrasound ◽  
Congenital Mesoblastic Nephroma ◽  
Common Causes ◽  
Renal Enlargement

Solid fetal renal masses are a rare finding on antenatal ultrasound, with hydronephrosis and cystic disease of the kidney usually being the most common causes for fetal renal enlargement. Herein we report a case of a solid fetal renal mass which was detected on third trimester antenatal ultrasound scanning. This renal mass was evaluated by MRI in the postnatal period and diagnosis confirmed by histological analysis, after surgical excision. Also discussed are the differential diagnoses and imaging features of other solid fetal renal masses, including congenital mesoblastic nephroma, nephroblastomatosis, renal sarcoma and angiomyolipoma.

Hook-wire assisted localization of a completely endophytic renal mass during three-dimensional laparoscopic partial nephrectomy: Presentation of our technique

2021 ◽  
pp. 039156032110318
Author(s):  
Nikolaos Ferakis ◽  
Spyridon Paparidis ◽  
Athanasios Papatheodorou ◽  
Evangelos N Symeonidis ◽  
Antonios Katsimantas
Keyword(s):  
Partial Nephrectomy ◽  
Renal Mass ◽  
Three Dimensional ◽  
Cost Effective ◽  
Surgical Excision ◽  
Laparoscopic Partial Nephrectomy ◽  
Cell Renal Cell Carcinoma ◽  
Renal Masses ◽  
Case Presentation ◽  
Hook Wire

Introduction: Totally endophytic renal masses may be invisible during laparoscopic partial nephrectomy, posing challenge to surgeons regarding tumor’s identification and resection. Case presentation: A 22-year-old male was incidentally diagnosed with a completely endophytic, cT1a renal mass. Percutaneous Computed Tomography-guided insertion of a hook-wire was performed prior to laparoscopic partial nephrectomy. The hook-wire anchored centrally into the tumor and its extra-renal part was easily identified intraoperatively, contributing to tumor’s identification and surgical excision. Total operative time was 185 min, warm ischemia time was 21.5 min, tumor excision time was 10 min, and total renorraphy time was 31 min. No complications were encountered perioperatively. The patient was discharged on the fourth postoperative day. Histology revealed a pT1a, clear-cell renal cell carcinoma, with negative surgical margins. Conclusions: Our first experience indicates that hook-wire guided excision of a completely endophytic renal mass during laparoscopic partial nephrectomy is feasible, safe, and cost-effective.

scholarly journals The diagnostic utility of diffusion weighted MRI imaging and ADC ratio to distinguish benign from malignant renal masses: sorting the kittens from the tigers

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suresh de Silva ◽  
Kathleen Rebecca Lockhart ◽  
Peter Aslan ◽  
Peter Nash ◽  
Anthony Hutton ◽  
...  
Keyword(s):  
Renal Mass ◽  
Clear Cell ◽  
Surgical Excision ◽  
Mri Imaging ◽  
Renal Masses ◽  
Post Contrast ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Apparent Diffusion ◽  
Adc Values

Abstract Background MRI is playing an increasing role in risk stratification and non-invasive diagnosis of the undifferentiated small renal mass. This study was designed to assess the reliability of MRI in diagnostic evaluation of renal masses, specifically characterising lesions with diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) values. Methods This is a retrospective analysis of patients undergoing MRI as part of their clinical workup for a renal mass suspicious for renal cell carcinoma (RCC) on CT or ultrasound followed by biopsy and/or surgical excision. All cases were conducted on 3 Tesla MRI, with conventional breath-held sequences, DWI and dynamic contrast enhanced phases. Tumour regions of interest were evaluated on ADC maps and compared with T2 weighted and post-contrast images. Results Of the 66 renal tumours included, 33 (50.0%) were Clear Cell RCC, 11 (16.7%) were Oncocytoma, nine (13.6%) were Angiomyolipoma (AML), nine (13.6%) were Papillary RCC and four (6.1%) were Chromophobe RCC. Oncocytoma had the largest ADC values, significantly larger than AMLs and all RCC subtypes (p < 0.001). The average ADC value was also significantly larger in Clear Cell RCCs compared to AMLs, and other RCC subtypes (p < 0.001). Conclusions MRI with DWI/ADC imaging may aid the differentiation of oncocytomas from RCCs and stratify RCC subtypes, Further studies are required to validate these findings. Trial registration: Not applicable/retrospective study.

scholarly journals Reproducibility and interobserver agreement of the R.E.N.A.L. nephrometry score: focus on imaging features

2017 ◽  
Vol 50 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Richard Mast Vilaseca ◽  
Antonio Carlos Westphalen ◽  
Henrique Ferreira Reis ◽  
Orlando Salomão Zogbi ◽  
Gyl Eanes Silva ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Interobserver Agreement ◽  
Surgical Excision ◽  
Renal Tumors ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Renal Masses ◽  
Anatomical Features ◽  
Nephrometry Score ◽  
Final Score

Abstract Objective: To investigate the reproducibility and interobserver agreement for R.E.N.A.L. nephrometry scoring system. Materials and Methods: Two independent radiologists retrospectively analyzed 46 consecutive patients with renal masses, between 2008 and 2012, using the R.E.N.A.L. nephrometry score (RENAL-NS), which is based on the evaluation of five anatomical features of the tumor, as evaluated with computed tomography or magnetic resonance imaging: Radius, Exophytic/endophytic properties, Nearness to the collecting system, Anterior or posterior descriptor, and Location relative to the polar line. Tumor complexity was graded as low, intermediate, or high. The interobserver agreement was calculated for the total score and for the score for each parameter. Surgical excision of the tumors was used as the standard of reference. Results: The interobserver agreement for each of the RENAL-NS parameters, respectively, a hilar location, and the total score was 98%, 80%, 100%, 89%, 85%, 89%, and 93% of patients, corresponding to kappa values of 0.96, 0.65, 1.00, 0.75, 0.72, 0.78, and 0.88, respectively. The Nearness, Radius, and total score showed the best agreement. For the cases that were discordant in terms of the final score, no major implications in surgical planning were observed. Conclusion: The RENAL-NS is a structured, useful system to assess the anatomical features of renal tumors. It is easily applicable and reproducible, even for less experienced radiologists.

Histologic Heterogeneity of Extirpated Renal Cell Carcinoma Specimens: Implications for Renal Mass Biopsy

2020 ◽  
Vol 7 (3) ◽  
pp. 20-25
Author(s):  
Lauren Nahouraii ◽  
Jordan Allen ◽  
Suzanne Merrill ◽  
Erik Lehman ◽  
Matthew Kaag ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Mass ◽  
Tumor Stage ◽  
High Grade ◽  
Renal Masses ◽  
Histologic Heterogeneity ◽  
Adequate Sampling ◽  
Renal Mass Biopsy

Pathologic characteristics of extirpated renal cell carcinoma (RCC) specimens <7  cm were reviewed to get better information on technical nuances of renal mass biopsy (RMB). Specimens were stratified according to tumor stage, nuclear grade, size, histology, presence of lymphovas-cular invasion (LVI), necrosis, and sarcomatoid features. When considering pT1 (0–7 cm) tumors pT1b (4–7 cm), RCC masses were more likely to have necrosis (43% vs 16%, P < 0.001), LVI (6% vs 2%, P = 0.024), high-grade nuclear elements (29% vs 17%, P < 0.001), and sarcomatoid features (2% vs 0%, P = 0.006) compared with pT1a (0–4 cm) tumors. Additionally, pT3a tumors were more highly associated with necrosis (P = 0.005), LVI, sarcomatoid features, and high-grade disease (P for all < 0.001) when compared to pT1 masses. For masses <4 cm, pT3a cancers were more likely to demonstrate necrosis (38% vs 16%, P < 0.001), LVI (10% vs 2%, P = 0.037), high-grade nuclear elements (31% vs 17%, P = 0.05), and sarcomatoid features (3% vs 0%, P = 0.065) compared to pT1a tumors. Similarly, for masses 4–7 cm, pathologic T3a tumors were significantly more likely to have sarcomatoid features (16% vs 2%, P < 0.001) and LVI (28% vs 6%, P < 0.001) compared to pT1b tumors. In summary, pT3a tumors and those RCC masses >4 cm exhibit considerable histologic heterogeneity and may harbor elements that are not easily appreciated with limited renal sampling. Therefore, if RMB is considered for renal masses greater than 4 cm or those that abut sinus fat, a multi-quadrant biopsy approach is necessary to ensure adequate sampling and characterization of the mass.

Renal mass biopsy: A strategy to reduce associated costs and morbidity when managing localized renal masses

2021 ◽  
Author(s):  
Abhishek Srivastava ◽  
Robert N. Uzzo ◽  
Jennifer Lee ◽  
Eric Cho ◽  
Alex Grieco ◽  
...  
Keyword(s):  
Renal Mass ◽  
Renal Masses ◽  
Renal Mass Biopsy

scholarly journals Pilomatrixoma, a Rare Mimicker of Male Breast Cancer

2019 ◽  
Vol 9 ◽  
pp. 46
Author(s):  
Aurela Clark ◽  
Rebecca Leddy ◽  
Laura Spruill ◽  
Abbie Cluver
Keyword(s):  
Benign Lesion ◽  
Surgical Excision ◽  
Male Breast ◽  
Skin Tumor ◽  
Imaging Features ◽  
Histologic Diagnosis ◽  
Outer Quadrant ◽  
Imaging Characteristics ◽  
Suspicious Feature

Pilomatrixoma or calcifying epithelioma of Malherbe is a benign skin tumor arising from the hair follicle; breast occurrence is considered a rarity. Clinically presenting as a palpable abnormality and with both benign and malignant mammographic and sonographic features, it can be easily misdiagnosed as a breast neoplasm. We report a very rare case of pilomatrixoma of the male breast in a 36-year-old male presenting with a firm, superficial nodule in the upper outer quadrant. Though the sonographic trifecta of imaging features (shape- margins-orientation/oval, circumscribed mass, parallel to the skin) is consistent with a benign lesion, a histologic diagnosis was warranted based on its most suspicious feature of internal pleomorphic calcifications. Pathologic diagnosis revealed the uncommon benign entity of pilomatrixoma in the male breast. Our patient was recommended for surgical excision based on current literature recommendations for management in most reports of pilomatrixoma. One alternative recommendation presented in a single report of pilomatrixoma in the breast supported follow-up imaging based on benign imaging characteristics.

scholarly journals Surgical cause of respiratory distress in a newborn

2021 ◽  
Vol 8 (9) ◽  
pp. 1629
Author(s):  
Vishnu Vardhan Reddy M. ◽  
Suguna Reddy C. ◽  
Yoga Nagendhar ◽  
Vardhini Sree D.
Keyword(s):  
Respiratory Distress ◽  
Growth And Development ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Normal Growth ◽  
Surgical Excision ◽  
Term Infant ◽  
Congenital Heart Diseases ◽  
Common Causes ◽  
Lobar Emphysema

Common causes of respiratory distress in a term infant include transient tachypnoea of newborn, sepsis/congenital pneumonia and congenital heart diseases. Surgical causes of distress in a newborn are rare and should be considered when other causes have been ruled out. We report a case of an early term female neonate who developed respiratory distress immediately after birth which was gradually progressive and required respiratory support. On evaluation with chest radiography and CT, a diagnosis of congenital lobar emphysema (CLE) was made. Immediate surgical resection was planned and done on day 8 of life. Post operatively she had no respiratory distress and discharged within a week. Baby is now healthy with normal growth and development. Half of the cases of CLE are diagnosed within the first 6 months of life but very few cases present with respiratory distress since birth. Timely diagnosis and early surgical excision in neonates <2 months improve the outcome, as seen in our case.

scholarly journals Diagnostic Dilemma of a Rare, Giant Retroperitoneal Schwannoma: A Case Report and Review of Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Mahendra Singh ◽  
Lovekesh Kumar ◽  
Rajkumar Chejara ◽  
Om Prakash Prasad ◽  
Yuvraj Kolhe ◽  
...  
Keyword(s):  
Low Frequency ◽  
Surgical Excision ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Postoperative Recovery ◽  
Cystic Mass ◽  
Imaging Features ◽  
Diagnostic Dilemma ◽  
Complete Surgical Excision ◽  
Retroperitoneal Schwannoma

Schwannoma is a benign tumour of peripheral nerve sheath. It usually arises from head, neck, and trunk. Retroperitoneal schwannoma is a rare entity, accounting for only 0.3–3% of total schwannomas. Majority of retroperitoneal schwannomas reported in literature have a diameter of 5 to 15 cm. Preoperative diagnosis is difficult due to low frequency, nonspecific clinical course, and nonspecific imaging features. Histology usually provides definitive diagnosis. Schwannomas are solitary, well-circumscribed, and noninvasive, so complete surgical excision provides good result. We report a case of a 23-year-old male, who presented with progressive abdominal distension and intermittent episodes of intestinal obstruction. CECT was suggestive of huge solid-cystic mass in abdominopelvic region. Image guided percutaneous aspiration revealed around 1 litre of frank pus and FNAC was suggestive of abscess. Exploratory laparotomy revealed a large 32 × 28 × 26 cm mass with solid and cystic components containing 1 litre of pus. Histological features of tumour were suggestive of benign schwannoma and immunohistochemistry for S-100 was positive. Postoperative recovery was uneventful. We report this case of a retroperitoneal schwannoma because of giant size, rare location, unusual presentation, and diagnostic dilemma.

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