Imaging of renal masses and staging of renal tumours

Renal cell carcinomas (RCCs) account 80–85% of all primary renal neoplasms and originate from the renal cortex. The patients who underwent radical or partial nephrectomy for renal tumour in our unit between January 2005 and 2015 were evaluated retrospectively. The patients were divided into two groups; group 1 includes patients who were treated between January 2005 and December 2009, group 2 those from January 2010 to 2015. There were 103 patients in group 1. The patients were between 21 and 89 years with mean age of 61.46 year. Renal cell carcinomas account 83.4% of the patients, benign renal tumours were 8.7% and transitional cell carcinomas were 7.7% of the patients in group 1. A total of 32.5% RCCs were classified as pT1a, 24.4% as pT1b, 15.1% as pT2a, 11.6% as pT2b, 15.1% as pT3a and 1.1% as pT4. There were 202 patients in group 2 and the patients were between 27 and 81 years with mean age of 58.5 year. Renal cell carcinomas comprised the main bulk of the tumours with 182 nephrectomy specimens. According to the pathological classification of RCCs, 51 specimens were found as pT1a, 54 were pT1b, 13 were pT2a, 14 were pT2b, 48 were pT3a and 2 were pT4. Although, the incidence of small renal masses has been increasing with widespread use of imaging techniques and recent advancements, the proportion of high grade and advanced stage renal tumours increased during the study period.

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Imaging renal masses and staging renal tumours

Imaging ◽

10.1259/imaging/16349669 ◽

2008 ◽

Vol 20 (1) ◽

pp. 73-86 ◽

Cited By ~ 3

Author(s):

L R Williams ◽

M J Oldale ◽

A J Bradley

Keyword(s):

Renal Masses ◽

Renal Tumours

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Primary renal lymphoma: a rare cause of renal mass in pediatric age group: case report and review of literature

International Surgery Journal ◽

10.18203/2349-2902.isj20203808 ◽

2020 ◽

Vol 7 (9) ◽

pp. 3127

Author(s):

Karishma Thakur ◽

Sonam Wadhwani ◽

Meha Ghodawat ◽

Advait Prakash ◽

Abhinav Khare ◽

...

Keyword(s):

Renal Mass ◽

Renal Involvement ◽

Review Of Literature ◽

Diagnostic Features ◽

Renal Masses ◽

Girl Child ◽

Pediatric Age Group ◽

Non Hodgkin Lymphoma ◽

Renal Lymphoma ◽

Renal Tumours

The secondary renal involvement of non-Hodgkin lymphoma is frequently encountered but primary renal lymphoma is extremely rare in children. We hereby present a rare case of primary renal diffuse lymphoma in a 3-year-old girl child who presented with bilateral renal masses. The tumour was initially diagnosed as bilateral Wilms’ tumour but on biopsy, it turned out to be non-Hodgkin's lymphoma. Primary renal lymphoma is an aggressive tumour with guarded prognosis. There are a variety of diseases which present as renal masses in children amongst which primary renal lymphoma is extremely rare. This article describes the clinical features and diagnostic features of primary renal lymphoma. Our report highlights the importance of keeping this neoplastic condition under consideration while evaluating children with renal mass .In order to distinguish primary renal lymphoma from other renal tumours, the authors have also described the clinical, imaging and pathological features of various other renal tumours prevalent in children.

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319 Systematic Review of Safety and Oncological Outcomes of Irreversible Electroporation in Renal Tumours

British Journal of Surgery ◽

10.1093/bjs/znab259.927 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

A Hilton ◽

G Kourounis ◽

F Georgiades

Keyword(s):

Thermal Effects ◽

Irreversible Electroporation ◽

Case Series ◽

Complete Response ◽

Renal Masses ◽

Oncological Outcomes ◽

Renal Tumours ◽

Higher Sensitivity

Abstract Introduction Thermal tumour ablation techniques are effective alternatives to nephrectomy for small renal masses (SRM). Thermal effects limit their use in tumours adjacent to vital structures. We review safety and oncological outcomes of irreversible electroporation (IRE), a novel non-thermal ablation technique, in SRMs. Method MEDLINE, EMBASE, and SCOPUS databases were interrogated up to 29/11/2020 for studies reporting safety and oncological outcomes for SRMs in humans treated by IRE. Results Of 224 results screened, 10 met the inclusion criteria. In total, 83 patients were identified. Except for one cohort study (n = 41), remaining studies were case series of n < 10. Follow up was <12 months in 7/10 articles (Range 3-34 months). 10/10 articles reported safety outcomes. There were no 30-day mortalities. The most reported adverse events were transient haematuria (11/83) and asymptomatic perirenal haematomas (7/83). 62/63 patients with reported length of stay were discharged within 24 hours. No significant long-term changes in renal function were reported. 7/10 articles reported oncological outcomes. Only 1 article assessed histopathology outcomes. Remaining studies used CT, PET, or MRI for assessment. 4/7 (57%) patients with histopathology outcomes, showed complete response (CR). 43/55 (78%) patients with imaging base outcomes, showed CR. No mortalities were reported due to SRMs. Conclusions Initial findings support IRE as safe and feasible in managing SRMs. Results from larger studies with longer follow-up are needed to evaluate oncological outcomes and compare these with other ablation methods. Discrepancy between CR rates in histopathology vs imaging assessment could indicate higher sensitivity of histopathology for assessing outcomes.

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An Exploratory Analysis of Changes in Circulating Plasma Protein Profiles Following Image-Guided Ablation of Renal Tumours Provides Evidence for Effects on Multiple Biological Processes

Cancers ◽

10.3390/cancers13236037 ◽

2021 ◽

Vol 13 (23) ◽

pp. 6037

Author(s):

Tze Min Wah ◽

Jim Zhong ◽

Michelle Wilson ◽

Naveen S. Vasudev ◽

Rosamonde E. Banks

Keyword(s):

Cell Proliferation ◽

Plasma Protein ◽

Individual Variation ◽

Inflammatory Responses ◽

Protein Profiles ◽

Renal Masses ◽

Image Guided ◽

Rational Development ◽

Renal Tumours ◽

And Migration

Further biological understanding of the immune and inflammatory responses following ablation is critical to the rational development of combination ablation-immunotherapies. Our pilot exploratory study evaluated the circulating plasma protein profiles after image-guided ablation (IGA) of small renal masses to determine the resultant systemic effects and provide insight into impact both on the tumour and immune system. Patients undergoing cryotherapy (CRYO), radiofrequency ablation (RFA) or microwave ablation (MWA) for small renal tumours were recruited. Blood samples were obtained at four timepoints; two baselines prior to IGA and at 24 h and 1–3 months post-IGA, and a panel of 164 proteins measured. Of 55 patients recruited, 35 underwent ablation (25 CRYO, 8 RFA, 2 MWA) and biomarker measurements. The most marked changes were 24 h post-CRYO, with 29 proteins increasing and 18 decreasing significantly, principally cytokines and proteins involved in regulating inflammation, danger-associated molecular patterns (DAMPs), cell proliferation, hypoxic response, apoptosis and migration. Intra-individual variation was low but inter-individual variation was apparent, for example all patients showed increases in IL-6 (1.7 to 29-fold) but only 50% in CD27. Functional annotation analysis highlighted immune/inflammation and cell proliferation/angiogenesis-related clusters, with interaction networks around IL-6, IL-10, VEGF-A and several chemokines. Increases in IL-8, IL-6, and CCL23 correlated with cryoprobe number (p = 0.01, rs = 0.546; p = 0.009, rs = 0.5515; p = 0.005, rs = 0.5873, respectively). This initial data provide further insights into ablation-induced biological changes of relevance in informing trial design of immunotherapies combined with ablation.

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