scholarly journals Upper tract imaging modality to investigate haematuria: cancer detection rates and changing guidelines

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Lee Chien Yap ◽  
Daniel Peter McNicholas ◽  
Anna L. Walsh ◽  
Abdul Rauf ◽  
Ken Patterson ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Detection Rate ◽  
Imaging Modality ◽  
Limited Resource ◽  
Ct Urography ◽  
Detection Rates ◽  
Upper Tract ◽  
Underlying Malignancy

Abstract Background To assess the imaging modalities used to investigate both visible haematuria and non-visible haematuria along with their detection rate of malignancy at two hospitals and the corresponding radiological workload produced. Methods A retrospective study was conducted across two hospitals. All CT urograms and ultrasound scans investigating haematuria in the outpatient setting over a 12-month period were evaluated. Results The detection rate for upper tract urothelial cancer with visible haematuria was 0.97% and for renal cell carcinoma was 0.64%. Of all the CT urograms performed for non-visible haematuria 4.9% had suspicious findings but none of these represents an underlying malignancy. Of all the ultrasound scans performed for either visible or non-visible haematuria, none were shown to have an underlying malignancy. The detection rate was thus zero for an upper tract urinary cancer or renal cell carcinoma in the non-visible haematuria group. A CT urogram was performed in 27% and 67% of cases in each respective hospital to further investigate non-visible haematuria. CT urography makes up 2.3% and 5.2% of each hospitals overall respective workload in the CT department. CT urography to investigate non-visible haematuria could be replaced by ultrasound in low-risk patients. Conclusions Radiological investigations are a limited resource and better rationalisation of upper tract imaging is needed in the setting of haematuria. Risk stratification of patients would be of benefit to help prevent a significant delay in timely diagnostics for higher risk individuals presenting with haematuria.

scholarly journals Spontaneous Rupture of Renal Cell Carcinoma: A Rare Case Report

2020 ◽  
pp. 1-3
Author(s):  
Richa Chauhan ◽  
Richa Chauhan ◽  
Gyanendra Singh ◽  
Upendra Prasad Singh
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Malignant Tumor ◽  
Renal Cell ◽  
Spontaneous Rupture ◽  
Renal Mass ◽  
Malignant Tumors ◽  
Imaging Modality ◽  
Benign Tumors ◽  
Contrast Enhanced Ct

Renal cell carcinoma (RCC) is an uncommon malignant tumor of the kidney, particularly in the Asian population. It is more commonly seen in an elderly male patient with typical complains of haematuria, flank pain and lump. Recently incidental diagnosis of small RCCs has been rising due to increased used of abdominal imaging for other reasons. Spontaneous rupture of a renal mass leading to large perinephric collection and presenting as an acute pain abdomen in an adult male is a rare finding but should be considered as a differential diagnosis. The most common cause of spontaneously ruptured renal mass includes benign tumor as angiomyolipoma followed by malignant tumor like RCC, vascular causes, coagulation defects and infection in other cases. Contrast enhanced CT scan is the most common imaging modality used for diagnosis. Initial resuscitation depending up on the patient’s general condition followed by nephrectomy for malignant tumors and embolization for benign tumors is the treatment of choice.

The prognostic value of the controlling nutritional status (CONUT) score on patients undergoing nephrectomy for upper tract urothelial carcinoma or renal cell carcinoma: a systematic review and meta-analysis

2021 ◽  
pp. 1-20
Author(s):  
Junhao Chen ◽  
Dehong Cao ◽  
Zhufeng Peng ◽  
Pan Song ◽  
Zhenghuan Liu ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Nutritional Status ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Subgroup Analysis ◽  
Renal Cell ◽  
Prognostic Value ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract ◽  
Conut Score

Abstract Background & aims: In recent years, the controlling nutritional status (CONUT) score has increasingly became an effective indicator associated with tumor prognosis. This study was conducted to synthesise data on the prognostic value of CONUT score on patients with upper tract urothelial carcinoma (UTUC) or renal cell carcinoma (RCC) undergoing nephrectomy. Methods: We designed and performed a systematic analysis of studies that verified the correlation between preoperative CONUT score and prognosis for UTUC and RCC using PubMed, Web of Science and Embase. The conclusion was clarified by pooled hazard ratios (HR) and 95% confidence intervals (95% CI). Subgroup analysis were further conducted in accordance with different primary tumor. Results: Six studies involving 3529 patients were included in this evidence synthesis, which revealed that the CONUT score had a potential role to predict the survival of UTUC and RCC patients accepting surgery. Pooled analysis showed that the overall survival (OS, HR 2.32, p<0.0001), cancer-special survival (CSS, HR 2.68, p<0.0001) and disease-free survival (DFS, HR 1.62, p<0.00001) were inferior in the high CONUT score group when compared with low score group. Subgroup analysis revealed that this result was in line with UTUC (OS: HR 1.86, P=0.02; CSS: HR 2.24, P=0.01; DFS: HR 1.54, P<0.00001) and RCC (OS: HR 3.05, P<0.00001; CSS: HR 3.47, P<0.00001; DFS: HR 2.21, P=0.0005) patients respectively. Conclusion: The CONUT score is a valuable preoperative index to predict the survival of patients with UTUC or RCC undergoing nephrectomy.

scholarly journals Two Different Upper Tract Urological Malignancies on Either Side

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
W. S. L. De Silva ◽  
S. R. De Almeida ◽  
G. D. B. J. Karunarathne ◽  
A. A. S. Samarathunga ◽  
K. M. C. S. Gannoruwa ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Mass ◽  
Transitional Cell ◽  
Upper Tract Urothelial Carcinoma ◽  
Malignant Neoplasms ◽  
Upper Tract ◽  
The Right

Introduction. The genitourinary system is a recognized site for multiple primary malignant neoplasms even without syndromic anomalies. However, to the best of our knowledge, a case of upper tract urothelial carcinoma (UTUC) with contralateral renal cell carcinoma (RCC) is not reported in surgical literature so far. Case Presentation. A 52-year-old Sri Lankan male patient was found to have a right lower ureteric tumour and a left renal mass together upon investigating for painless visible hematuria. The right ureteric tumour measured 32 × 22   mm resulting in moderate hydronephrosis and cortical thinning of the right kidney, and the left renal mass measured 43 × 38   mm involving the lower pole. The biopsy of the right ureteric lesion revealed a high-grade transitional cell carcinoma with focal nested pattern and that of the left renal mass revealed a clear cell carcinoma. Right nephroureterectomy followed by a left partial nephrectomy was performed in six weeks’ interval. The histology of both the resected specimens confirmed the biopsy findings. Discussion. A high-risk upper tract urothelial carcinoma such as the right ureteric tumour of this patient required a nephroureterectomy which makes the management of the contralateral renal cell carcinoma more complex. An adequate functional renal remnant was ensured after offering oncologically sound surgical treatment for both the malignancies of this patient. Conclusion. A UTUC when associated with a contralateral RCC poses challenges in patient management. The preservation of renal excretory function has to be considered as an important determinant in addition to oncologically sound surgical resection when managing complex cases of genitourinary malignancies involving both sides of the upper urinary tract.

Comparing Changes in Renal Function After Radical Surgery for Upper Tract Urothelial Carcinoma and Renal Cell Carcinoma

Urology ◽  
2016 ◽  
Vol 96 ◽  
pp. 44-53 ◽  
Author(s):  
Nirmish Singla ◽  
Ryan Hutchinson ◽  
Colleen Menegaz ◽  
Ahmed Q. Haddad ◽  
Lai Jiang ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Renal Function ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Surgery ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract

Rare case of recurrent renal cell carcinoma with tumour thrombosis of circumaortic renal vein

2020 ◽  
Vol 4 (3) ◽  
pp. 109-111
Author(s):  
Ashwini Hule ◽  
Sanjay Desai
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Vein ◽  
Rare Case ◽  
Renal Neoplasm ◽  
Ct Urography ◽  
Neoplastic Lesion ◽  
Clear Delineation ◽  
Recurrent Renal Cell Carcinoma

Renal cell carcinomas are the most common renal neoplasm with high mortality. Recurrence of neoplasm is not uncommon following treatment. However, we present an extremely rare case of 74-year-old male patient of recurrent renal cell carcinoma with tumour thrombosis into left circumaortic vein which has not been reported previously in literature to our best knowledge. CT urography is the study of choice for clear delineation of the site and extension of the neoplastic lesion. Rare venous anomalies of renal vein are of utmost importance in order to plan surgical management and prognosis in follow-up cases especially after partial nephrectomy.

F-18 Fluorodeoxyglucose Positron Emission Tomography in the Evaluation of Distant Metastases From Renal Cell Carcinoma

2003 ◽  
Vol 21 (21) ◽  
pp. 3995-4000 ◽  
Author(s):  
Navneet S. Majhail ◽  
Jean-Luc Urbain ◽  
Justin M. Albani ◽  
Mangesh H. Kanvinde ◽  
Thomas W. Rice ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Fdg Pet ◽  
Renal Cell ◽  
Imaging Modality ◽  
False Negative ◽  
Distant Metastases ◽  
Emission Tomography ◽  
Positron Emission

Purpose: We conducted a study to evaluate the role of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in the detection of distant metastases from renal cell carcinoma (RCC). Materials and Methods: Twenty-four patients with histologically proven clear-cell RCC undergoing surgical evaluation for possible resection of recurrent disease were investigated. All patients had suspected distant metastases based on conventional anatomic imaging techniques (computed tomography and magnetic resonance imaging). A total of 36 distant metastatic sites were identified. Pathology for all sites was obtained by biopsy or after surgical resection. Results: Histologically documented distant metastases from RCC were present in 33 sites (21 patients). Overall sensitivity, specificity, and positive predictive value of FDG-PET for the detection of distant metastases from RCC was 63.6% (21 of 33), 100% (three of three), and 100% (21 of 21), respectively. The mean size of distant metastases in patients with true-positive FDG-PET was 2.2 cm (95% CI, 1.7 to 2.6 cm) compared with 1.0 cm in patients with false-negative FDG-PET (95% CI, 0.7 to 1.4 cm; P = .001). Conclusion: FDG-PET is not a sensitive imaging modality for the evaluation of metastatic RCC and may not adequately characterize small metastatic lesions. However, positive FDG-PET is predictive for the presence of RCC in lesions imaged, may complement anatomic radiologic imaging modalities, and may alleviate the need for a biopsy in selected situations. A negative FDG-PET, however does not rule out active malignancy.

scholarly journals Xp11 Translocation Renal Cell Carcinoma: Unusual Variant Masquerading as Upper Tract Urothelial Cell Carcinoma

2014 ◽  
Vol 2 (3) ◽  
pp. 75-77
Author(s):  
Arash Akhavein ◽  
Julia Han ◽  
Christopher Carter ◽  
Samer Z. Al-Quran ◽  
Li-Ming Su
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Urothelial Cell ◽  
Urothelial Cell Carcinoma ◽  
Upper Tract ◽  
Unusual Variant

scholarly journals Renal cell carcinoma of horseshoe kidney

2020 ◽  
pp. 72-72
Author(s):  
Milomir Tufegdzic ◽  
Vladimir Vasic ◽  
Jovan Hadzi-Djokic
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Renal Cell ◽  
Horseshoe Kidney ◽  
Ct Urography ◽  
Lower Pole ◽  
Macroscopic Hematuria ◽  
Patient Reported ◽  
The Right

Introduction. Horseshoe kidney is the most common developmental disorder of the urinary system, which involves an anomaly of kidney fusion, and occurs in 3% of the population. Kidneys are most often connected at the lower poles by fibrous or parenchymal isthmus. Renal cell carcinoma (RCC) is the most common tumor of the horseshoe kidney. Treatment involves surgical treatment that includes heminephrectomy or partial nephrectomy with different approaches. We report a case of RCC of a horseshoe kidney, located on lower pole and isthmus. Case outline. A sixty-eight-year-old patient reported to the urologist due to intermittent painless macroscopic hematuria. CT urography revealed the presence of a tumor on the right kidney measuring 85 ? 90 ? 60 mm, with radiological characteristics of RCC, which covered the entire lower pole of the kidney towards the isthmus. Angiography finding indicated thickened isthmus with pronounced malformation of vascular structures. The right heminephrectomy was performed with resection of the isthmus from 15 mm to healthy tissue. The isthmus was sutured in two layers with a catgut suture. Subsequently, hilar, paracaval, and interaorthocaval lymphadenectomy were performed. The pathohistological finding indicated a tumor of renal cell origin while the resection line was free of tumor tissue, as were the lymph nodes Conclusion. RCC is the most common neoplasm of the horseshoe kidney. Treatment is surgical and involves open or laparoscopic heminephrectomy or partial nephrectomy with a transperitoneal or extraperitoneal approach.

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