Abstract
Despite the development of recent imaging modalities, certain pathological misdiagnoses remain for surgical specimens of presumed small renal cell carcinomas (RCCs). In the present study, a retrospective analysis of benign pathological lesions diagnosed as small RCC prior to surgery was performed. In total, the cases of 196 sporadic renal tumors that was surgically treated as clinical T1a RCCs were reviewed, and the accuracy of the pathological diagnoses was calculated. The pre-operative findings for benign pathological lesions was investigated, and the lesions were observed in 13 (6.63%) of the 196 tumors. Pre-operative computed tomography images were obtained in all cases, and magnetic resonance images were available in 10 cases. The diagnostic accuracy of imaging modalities was significantly lower in the tumors with a diameter of ≤20 mm. In all cases, the possible pathological diagnosis of RCC could not be excluded even by retrospective imaging analysis. Several benign pathological lesions were found in small renal masses presumed to be clinical T1a RCC. In conclusion, there may be limitations to the pre-operative imaging for certain types of small renal mass.
Highlights
In 2012, an estimated 338,000 novel cases of renal cancer were diagnosed worldwide [1]
The incidence rate of benign lesions among clinical cases of presumed T1a renal cell carcinoma (RCC) in surgical specimens ranges from 7.1‐19.5% [5,6,7,8]
A pre‐operative diagnosis of clinical T1a RCC was made in 196 cases
Summary
In 2012, an estimated 338,000 novel cases of renal cancer were diagnosed worldwide [1]. The detection rate of renal tumors has increased due to the widespread use of imaging techniques, such as ultrasonography and computed tomography (CT). These imaging modalities enable the clinical diagnosis of almost all tumors pre‐operatively. The incidence rate of benign lesions among clinical cases of presumed T1a renal cell carcinoma (RCC) in surgical specimens ranges from 7.1‐19.5% [5,6,7,8]. It is difficult to distinguish benign small renal lesions, including oncocytoma, angiomyolipoma (AML) and compromised cysts, from clinical T1a RCC by routine examinations prior to surgery [5,6,7,8]
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