Téma: 

Observation on small solid renal masses less than 4 cm in diameter – growth and progression rates of enhancing and non-enhancing renal masses.

Peter Weibl, Ivan Lutter, Milan Obšitník, Marek Ondriš, Matulliah Karwandgar, Martin Romančík, Táňa Gajdošová, Marína Kraľovičová, Martin Blažek

Objective: The aim of our study was to evaluate the progression of enhancing and non-enhancing solid renal masses during the follow-up period by serial helical CT scans. Materials and methods: In this prospective study 19 patients were enrolled and divided in two groups; 1. 10 pts with solid enhancing renal mass in high preoperative risk unfit for surgery, advanced age or according to patient’s wishes. All lesions had pathological enhancement on post contrast CT scan (> 20 HU); 2. 9 patients had a CT finding of single solid renal mass without pathological enhancement (< 15 HU on nephrographic phase CT images), these lesions were categorized as non-enhancing solid renal masses or hyperdense renal cysts. The mean diameter of the lesion at presentation was 2.9 cm (range 1.9 from to 3.5 cm)-in group 1.; 3.1 cm (range from 1.5 to 4 cm)-in group 2. The mean period of observation was 2.5 and 2.1 years (range 1 to 3 yrs) for both groups respectively. Results: Group 1. the mean increase diameter after 1 year was 0.5 cm (range 0.1 from to 0.9 cm) ; 1 patient underwent radical nephrectomy (histology confirmed RCC pT1b, Fuhrman Gr. 3). In group 2. 2 patients underwent partial nephrectomy because of significant enhancement (in all cases final histology confirmed RCC pT1a, Fuhrman Gr. 1 - 2), the mean increase in diameter after 1 year was 0.2 cm (range from 0.1 to 0.5 cm). Conclusions: The vast majority of small enhancing renal masses grow at a slow rate when observed. Observation on nonenhacing solid renal masses according to our preliminary results seems as an effective approach. Growth rates of enhancing masses were 2.65x higher compared to non-enhancing renal masses.
Keywords: solid renal lesions, small renal masses, enhancing and non - enhancing renal lesions, observation and progression of RCC

Ročník 2006  Témy časopisu Clinical urology 2 / 2006

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