Learning objectives
The purposes of this educational exhibit are:
To enumerate and categorize the different renal masses and their radiological features;
To discriminate between benign and malignant renal lesions.
Background
The detection rate of renal masses has increased in the last decades owing to the widespread use of imaging techniques.
Therefore,
an accurate characterisation is essential to ensure appropriate case management [1].
The approach to a renal mass first begins with an image analysis to be sure that the finding is indeed a true renal mass.
Conditions that mimic a renal mass should be excluded [2].
Trauma,
infarction,
hemorrhage,
and infection may be incidental; each of these conditions can cause mass-like enlargement of a portion...
Findings and procedure details
Angiomyolipoma
Angiomyolipoma (AML) is the most common benign solid renal tumor.
Most AMLs are composed of variable amounts of fat,
smooth muscle and abnormal blood vessels.
AMLs can be associated with tuberous sclerosis (20% of cases).
The risk of hemorrhage is related to the size of the tumor,
and it is significantly higher in lesions greater than 4 cm in diameter (Fig 4).
On US,
AML is a circumscribed,
highly reflective mass,
more echogenic than the central sinus fat; renal cell carcinoma is also hyperechoic,...
Conclusion
Owing to the widespread use of abdominal imaging studies,
the detection rate of solid renal masses has increased.
Characterization of imaging features has become essential for management and therapeutic decision-making process.
The major question to be answered is whether the mass represents a surgical or nonsurgical lesion or if follow-up studies are necessary.
Careful evaluation of imaging finding combined with the patient's history should assist the radiologist in making the proper diagnosis.
References
1.Leo Pallwein-Prettner,
Daniel Flöry,
Claus Raphael Rotter,
Kurt Pogner,
Gerhard Syré,
Claudia Fellner,
Ferdinand Frauscher,
Friedrich Aigner,
Frens Steffen Krause,
Franz Fellner.Assessment and characterisation of common renal masseswith CT and MRI.Insights Imaging (2011) 2:543–556.
2.Stuart G.
Silverman,Gary M.
Israel,
Brian R.
Herts,
Jerome P.
Richie.Management of the IncidentalRenal Mass.Radiology 2008; 249:16–31.
3.Ray Dyer,David J.
DiSantis,
Bruce L.
McClennan.Simplified Imaging Approach forEvaluation of the Solid Renal Mass in Adults.Radiology: Volume 247: Number 2—May 2008 331.
4.Byung Kwan Park.Renal Angiomyolipoma: RadiologicClassification and Imaging Features According to the...