PD14-04 SPECTRUM OF RADIOLOGICAL FINDINGS OF HEREDITARY LEIOMYOMATOSIS AND RENAL CELL CANCER (HLRCC).

Field: Medicine (Health Sciences)

You have accessJournal of UrologyImaging/Radiology: Uroradiology IV1 Apr 2016PD14-04 SPECTRUM OF RADIOLOGICAL FINDINGS OF HEREDITARY LEIOMYOMATOSIS AND RENAL CELL CANCER (HLRCC). Jana Lovell, Andrew Dwyer, Elizabeth Jones, Nikeith Shah, Rabindra Gautam, Ishan Asokan, Adam Metwalli, Ramaprasad Srinivasan, W. Marston Linehan, and Ashkan Malayeri Jana LovellJana Lovell More articles by this author , Andrew DwyerAndrew Dwyer More articles by this author , Elizabeth JonesElizabeth Jones More articles by this author , Nikeith ShahNikeith Shah More articles by this author , Rabindra GautamRabindra Gautam More articles by this author , Ishan AsokanIshan Asokan More articles by this author , Adam MetwalliAdam Metwalli More articles by this author , Ramaprasad SrinivasanRamaprasad Srinivasan More articles by this author , W. Marston LinehanW. Marston Linehan More articles by this author , and Ashkan MalayeriAshkan Malayeri More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1001AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients with hereditary leiomyomatosis and renal cell cancer syndrome (HLRCC) are at increased risk of developing benign renal cysts and early-onset RCC, typically papillary carcinoma type II. Tumors are aggressive and have high metastatic potential even while small in size. Serial renal imaging of these patients is recommended to enable early detection of RCC. However, the radiologic appearance of RCC lesions in these patients is highly variable and there has been no characterization of the spectrum of findings. The aim of this study is to describe the range of CT and MR appearances of RCC in patients with HLRCC to facilitate accurate diagnosis. METHODS This study included 18 patients with 20 histologically-confirmed HLRCC lesions that were surgically removed or after contrast-enhanced CT and/or MR. All patients were evaluated at the National Cancer Institute Urological Oncology Branch. The lesions’ findings on preoperative CT and MR were determined by two radiologists by independent retrospective review of the studies. The tumors were assessed for presence of cystic components and enhancement, homogeneity/heterogeneity (Figure 1), and definition of margins. Abdominal lymph node enlargement was also assessed. RESULTS On CT, 9 (45%) lesions were predominantly cystic with nodules and/or septations; 5 (25%) were homogeneously cystic; 4 (20%) were heterogeneously solid; and 1 (5%) was homogeneously solid. On MR, 9 (45%) lesions were predominantly cystic with nodules and/or septations; 6 (30%) lesions were homogenously cystic; and 5 (25%) were homogenously solid. Of patients with homogeneously cystic lesions, only 1 (14.3%) patient presented with nodal involvement; however, an additional heterogeneous renal lesion was identified in this patient. In contrast, lymph node involvement was identified in 9 (75%) patients who had heterogeneous lesions or homogeneous solid lesions. CONCLUSIONS The majority of RCCs in HLRCC patients are predominantly cystic with some lesions appearing as simple homogenous cysts. The suspicion for malignant potential of lesions read as small simple cysts on CT or MR should remain high in patients with HLRCC. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e304 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Jana Lovell More articles by this author Andrew Dwyer More articles by this author Elizabeth Jones More articles by this author Nikeith Shah More articles by this author Rabindra Gautam More articles by this author Ishan Asokan More articles by this author Adam Metwalli More articles by this author Ramaprasad Srinivasan More articles by this author W. Marston Linehan More articles by this author Ashkan Malayeri More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...