Learning objectives
- what is renal cystic mass
- list of cystic renal masses in childhood
- which renal cystic masses are observed during infancy and childhood and which could be seen on fetal ultrasound
- what is the radiological differential diagnosis of renal cystic masses
- what is the preferred imaging method for diagnostics and follow-up
- are there any associated conditions
Background
The most common abdominal masses in childhood are of renal origin.
Cystic renal diseases are the most common abdominal masses in neonatal age.
Cystic renal disease is defined as development of abnormal cyst with or without normal parenchyma in the affected kidney.
Ultrasound is the preferred imaging method due to their cystic component and MRI may be used further. It is crucial to differentiate hydronephrosis from cystic tumor.
Findings and procedure details
We suggest and describe the following classification of the cystic renal masses in children:
1. Neoplasia (benign and malignant,
both groups present as large abdominal mass)
1.1. Mesoblastic nephroma
1.2. Multilocular Cystic Renal Tumor
1.3. Wilms tumour – cystic form
2. Congenital ciliopathies (genetic) *
2.1. Polycystic renal disease (autosomal dominant and autosomal recessive)
2.2. nephronophthisis - medullary cystic disease complex
3. Dysplastic renal diseases
3.1. Multicystic Dysplastic Kidney
3.2. Glomerulocystic Kidney Disease
4. Multiple Malformation Syndromes with Renal Cysts- tuberous sclerosis,
von Hippel-Lindau disease...
Conclusion
Cystic masses in kidneys are common.
They tend to be fast growing and obscuring the normal renal parenchyma which leads to nephrectomy.
Imaging diagnostics especially ultrasound can be safely used in diagnostics,
follow-up and differentiation between hydronephrosis and cystic tumor.
References
• Pediatr Nephrol.
1993 Aug;7(4):464-70.
Glomerulocystic kidney disease--nosological considerations.
Bernstein J1.
• From the Radiologic Pathology Archives Pediatric Polycystic Kidney Disease and Other Ciliopathies: Radiologic-Pathologic Correlation Ellen M.
Chung,
MD,
COL,
MC,
USA RadioGraphics 2014; 34:155–178
• EDUCATIONAL REVIEW Glomerulocystic kidney disease John J.
Bissler Brian J.
Siroky Hong Yin Pediatr Nephrol (2010) 25:2049–2059
• Imaging in cystic renal disease R de Bruyn,
I Gordon Arch Dis Child 2000;83:401–407
• Imaging and Classification of Congenital Cystic Renal Diseases Fred E.
Avni DOI:10.2214/AJR.11.8083 AJR 2012; 198:1004...