Benign Etiology Research Articles

Bacteriobilia frequency in patients afflicted by biliary obstruction at a tertiary care center

Background: Bile typically remains sterile within individuals possessing a normal biliary tract, but bacterial colonization arises with biliary obstruction. Infections often stem from ascending duodenal infection or bacterial translocation from the portal vein. Elevated common bile duct pressure due to obstruction, combined with infected bile, can lead to bacterial backflow into lymphatics, fostering cholangitis. In this study, 30 sequential bile samples were examined, scrutinizing the occurrence of bacteriobilia and comparing its incidence between benign and malignant etiologies. Aims and Objectives: Bacteriobilia typically manifests without symptoms. This study aimed to assess the prevalence of bacteriobilia in patients with obstructive jaundice undergoing endoscopic retrograde cholangiopancreatography (ERCP) at our institution, investigating associated risk factors. Furthermore, the study aimed to elucidate the microbiological profile of bile in obstructed biliary systems, make a comparative analysis of bacteriobilia frequency between benign and malignant obstructions, and delve into the drug sensitivity patterns of bacteria cultured from bile at our center. Materials and Methods: In a prospective, observational, and diagnostic study conducted at the Department of Digestive Health and Diseases, Government Peripheral Hospital, Anna Nagar, Chennai, from September 2011 to February 2012, with ethical committee approval and informed consent from all participants, we investigated 30 consecutive patients who underwent ERCP for biliary obstruction. The study cohort comprised 13 males and 17 females. Following successful biliary cannulation, bile samples were collected and subjected to microbiological analysis. Results revealed positive bile cultures in 16 patients, with 10 exhibiting benign etiology and 6 malignant. Gram-negative organisms, predominantly Klebsiella, were identified, displaying favorable susceptibility to cephalosporins while demonstrating resistance to ciprofloxacin. Results: Bile cultures yielded positive results in 16 patients, with 10 cases attributed to benign etiology and 6 to malignant etiology. The cultured organisms were predominantly Gram-negative, with Klebsiella exhibiting significant growth. Notably, these organisms exhibited favorable susceptibility to cephalosporins while displaying resistance to ciprofloxacin. Conclusion: Bile culture serves as a valuable tool for prompt diagnosis and pre-emptive management of complications. Gram-negative bacilli infections prevail within obstructed biliary systems. This study underscores the pivotal role of routine bile sampling during ERCP in obstructed biliary systems, offering predictive insights to avert complications like cholangitis.

Acute onset of purpura and fever: A rare but benign etiology

Acute onset of purpura and fever: A rare but benign etiology

Hepatic portal venous gas in the setting of closed loop small bowel obstruction in a patient with adjustable gastric band: a case report

Background: Hepatic portal venous gas (HPVG) has rarely been described in the presence of benign, non-life-threatening conditions such as gastric emphysema and gastric dilatation. In such cases, management and patient prognosis have evolved to become highly dependent on the etiology. Nevertheless, although such conditions can be benign and conservative management can be applied, close monitoring of the patient's status is necessary to avoid any complication like gastric necrosis. Case Presentation: We report a case of acute gastric dilatation with HPVG in the presence of gastric emphysema and closed loop small bowel obstruction, complicated by gastric necrosis, in a patient with adjustable gastric band. Conclusion: HPVG can have benign etiologies which influence its mortality rate, management, and prognosis. These should be detected, and patients should be monitored closely, especially if managed conservatively, to avoid complications.

Practical guidelines in case of nipple discharge

Nipple discharge is a frequent reason for women to consult their physician, led by the fear of cancer. Fortunately, almost 90 % of cases have a benign aetiology. The main challenge is to rule out any malignant pathology by collecting a detailed history and clinical exam in order to define a targeted imaging. The aim of this review is to facilitate the management of nipple discharge. The most common aetiologies of nipple discharge are described, along with a systematic clinical approach to exclude any underlying malignancy and minimize invasive examinations.

Cytomorphological analysis of effusion fluids for detection of malignant cells in a tertiary care hospital in northern India.

All body cavities are lined by monolayered mesothelial cells and contain a minimal amount of fluid for lubrication and for protecting the underlying viscera. The peritoneal, pleural, cerebrospinal, sputum, urine, and pericardial fluids comprise the major chunk of body fluids. The study was conducted in the Department of Pathology of a tertiary care hospital in northern India, over a period of 1 year, from January 2021 to December 2021. A total of 241 samples were included in the study. Out of the 241 samples studied, 99 were peritoneal fluid, 94 were pleural fluids, 29 were CSF, and 18 were sputum samples. Maximum number of patients affected were in the age group of 41-50 years. Female preponderance was seen with male to female ratio of 1:1.7. A total of 143/241 cases (59.33%) were of transudative nature and 98/241 (27.8%) cases were exudative. Out of 241 cases, 43 (17.84%) were neoplastic, 190 (78.83%) were non-neoplastic, four (1.65%) were suspicious for malignancy, and four (1.65%) were where no opinion was possible. Peritoneal fluid was the most frequently encountered fluid accounting for 99 cases (41.07%). Adenocarcinoma was the most common malignancy accounting for 29 cases (67.44%) out of 43 malignant effusions in the present study. Cytological evaluation of body fluids is of significant utility in diagnostic medicine as it allows us to distinguish between benign and malignant etiologies and at the same time offers rapid diagnosis and staging of metastatic disease.

Endobronchial inflammatory polyps

Endobronchial inflammatory polyps are one of the rarest benign bronchial tumors. Tumors of benign etiology are even rare. Inflammatory bronchial polyps are frequently solitary although rarely can be multifocal. We are presenting a rare case of multiple endobronchial inflammatory polyps presenting as pneumonia.

A TROJAN HORSE NEVER TO BE MISSED IN ELDERLY – AN INTRESTING CASE OF RIGHT ILIAC FOSSA MASS

We report a case of an elderly patient presenting with the right iliac fossa mass. The provisional diagnosis included an inammatory appendicular mass or abdominal wall mass. Interestingly, initial non-contrast computed tomography (CT) of the abdomen and pelvis, lap parameters and colonoscopy guided biopsy demonstrated the inammatory changes. Follow up imaging by contrast CT threw light on a new path towards the neoplastic etiology. Even after the follow up imaging the subsequent colonoscopy guided biopsy showed features suspicious for malignancy whereas cystoscopy guided biopsy showed benign features. Intra-operatively bowel neoplasm with bladder invasion was seen and right hemicolectomy with partial cystectomy done. Post-operative specimen nally revealed mucinous adenocarcinoma of caecum with urinary the bladder invasion. In the presented case, non-contrast CT ndings and clinico-pathological reports suggestive of a benign etiology were misleading. This could have been prevented if the patient was subjected to contrast study in view of her elderly age. This case highlights the importance of imaging in patient management. Therefore, we feel that it is important to share our experience of the successful management of the presented case.

Lumbar Intradural Intramedullary Epidermoid Cyst: A Case Report

Epidermoid cysts have a benign etiology and can be either congenital, usually associated with malformations, or acquired, related to external events, and even iatrogenic. As for their location, they are classified as extradural, intradural, extramedullary, and intramedullary. Intradural intramedullary epidermoid cysts are quite uncommon, with few cases reported in literature so far. Because of its slow growth, there may be a delay in diagnosis. Its symptoms depend on lesion’s topography, and total cyst removal is recommended to improve the condition. In this paper, we report the case of an adult patient with progressive spastic crural paraparesis, without associated malformations. Imaging exams showed an intradural intramedullary epidermoid cyst, which was completely removed, with subsequent improvement of patient’s clinical status.

Interventions for superior vena cava syndrome.

Superior vena cava (SVC) syndrome refers to the clinical manifestations of cerebral venous hypertension secondary to obstruction of the SVC and/or the innominate veins. The most common cause of SVC syndrome is malignancy like small cell lung cancer and non-Hodgkin lymphoma, but there is an increasing trend of benign etiologies secondary to thrombosis due to central lines/ pacemakers or mediastinal fibrosis. Supportive measures include head elevation, diuresis, supplemental oxygen, and steroids. Thrombolysis with or without endovenous stenting is required emergently in those with airway compromise or symptoms secondary to cerebral edema. Definitive treatment in those with malignancy is multidisciplinary; this requires radiotherapy, chemotherapy, SVC stenting, oncologic surgery and SVC bypass or reconstruction. Endovascular treatment is the primary modality for palliation in malignancy and in those with benign etiology. Surgery is reserved for those who have failed or are unsuitable for endovascular treatment. In patients with benign disease endovenous stenting and open surgery provide excellent symptom relief and are safe and effective.

Assessment of diaphragmatic role in dyspneic patients with pleural effusion

BackgroundDyspnea that is caused by pleural effusion and affects patients’ quality of life may not be resolved after lung expansion following pleural tapping. This study aims to investigate the role that changes in the diaphragmatic shape and movement play in the development of dyspnea in those patients.MethodsThirty patients with pleural effusions and dyspnea were evaluated before and at 24 h after therapeutic thoracentesis. The primary outcomes are to investigate changes in diaphragmatic shape and movement before and after thoracentesis by chest ultrasound to evaluate factors causing effusion-related dyspnoea, while the secondary outcomes are firstly to investigate the effect of pleural effusion on the cardiorespiratory, functional, and diaphragmatic variables in causing dyspnea and secondly to detect the percentages and demographics of patients who experience post-drainage dyspnea improvement.ResultsThirty patients with age >18 years old who had moderate to massive pleural effusion (either of benign or malignant etiology), with breathlessness were recruited from the Chest Department, Ultrasonography Unit, Ain-Shams University Hospitals. Almost all (96.7%) of the studied patients experienced shortness of breath with a mean modified Borg Score of 5.13 ± 1.78, tapping of varying amounts of pleural fluid ranging from 1000 to 2000 ml.There is a highly significant improvement in the diaphragmatic excursion, with non-significant improvement in diaphragmatic shape, although nonsignificant correlation between diaphragmatic excursion and functional parameters (M. Borg score, spirometry, and 6MWD: 6-min walk distance), but a significant negative correlation between diaphragmatic excursion and amount of drained effusion (P value 0.045 and 95% CI for OR 1.041–36.779). 63.3% of patients experienced dyspnea improvement after thoracocentesis, and they showed highly significant improvements in M. Borg dyspnea score, spirometry, pulse rate, respiratory rate, 6MWD, and blood oxygen saturation.ConclusionIn this study, we conclude that the improvement of the diaphragmatic excursion was negatively correlated with the amount of drained effusion, but no significant correlation was detected with the functional parameters and effusion-related indices that may be caused by the small sample size of the study.

What is this bump in my neck? Ultrasonographic evaluation of pediatric neck masses.

Neck masses are common in pediatric patients, with benign etiologies such as congenital or inflammatory lesions accounting most of these masses. Anatomic location (most important), clinical history, and the appearance in ultrasonography (US) are helpful clues to narrow down differential diagnosis. Because of widespread availability, lack of ionizing radiation, and no need for sedation or contrast administration, US is the preferred initial modality for the evaluation. Further evaluation with cross-sectional imagings is needed for more extensive lesions with trans-spatial extension or suspicion of intrathoracic or retropharyngeal extension. This review will focus on US appearance and clinical presentation of masses of the neck in children, to enable radiologist to arrive at a reasonable differential diagnosis. We also briefly discuss more complex pathologies that need to be evaluated with cross-sectional modalities such as CT scan and magnetic resonance imaging.

Biliary system interventions : Percutaneous transhepatic cholangiodrainage to bilioma

Avariety of transhepatic percutaneous biliary procedures are appropriate for the treatment of pathologies of the biliary system. The aim of this article is to describe best practices for performing percutaneous transhepatic cholangiography with placement of abiliary drain (PTCD), percutaneous transhepatic removal of bile duct stones, percutaneous stenting of the bile ducts, and percutaneous treatment of postoperative bilioma. The authors reviewed existing literature on relevant current recommendations and presented them based on their own facility's approach. Biliary interventions are mostly aimed at treating some form of cholestasis of benign or malignant etiology. The technical success rate is up to 90%. Percutaneous biliary interventions are safe and effective procedures in the treatment of pathologies of the biliary system, preferably used when endoscopic access is not possible due to anatomical conditions.

Abnormal TSH Prior to Surgery in Children with Graves' Disease Predicts Abnormal TSH Following Thyroidectomy.

To identify variables that are associated with poor compliance to thyroid hormone replacement therapy in children after total thyroidectomy. A retrospective cohort study of children who underwent total thyroidectomy by high-volume pediatric otolaryngologists between 1/2014 and 9/2021. Postoperative poor compliance was characterized by at least three separate measurements of high TSH levels not associated with radioactive iodine treatment. There were 100 patients, ages 3-20 years old who met inclusion criteria; 44 patients underwent thyroidectomy for cancer diagnosis, and 56 for Graves' disease. The mean follow-up time was 36.5 months (range 3.0-95.6 months). Overall, 42 patients (42%) were found to have at least three measurements of high TSH during follow-up, and 29 patients (29%) were diagnosed with clinical hypothyroidism. Sex, race, income, insurance type, and benign versus malignant etiology for thyroidectomy were not associated with adherence to therapy. Multivariate regression analysis identified patients with Graves' disease and hyperthyroidism at the time of surgery and Hispanic ethnicity to be associated with postoperative clinical hypothyroidism (OR 9.38, 95% CI 2.16-49.2, p=0.004 and OR 6.15, 95% CI 1.21-36.0, p=0.033, respectively). Preoperative hyperthyroidism in patients with Graves' disease and Hispanic ethnicity were predictors of postoperative TSH abnormalities. Preoperative counseling for patients and their families on the implications of total thyroidectomy and the need for life-long medications postoperatively is necessary. Efforts should be made to evaluate and improve adherence to therapy pre-and postoperatively in patients with Graves' disease. 4 Laryngoscope, 133:2402-2406, 2023.

Prostate Adenocarcinoma With Atypical Immunohistochemistry Presenting With a Cheerio Sign

The most common cancer in men is prostate cancer. The Cheerio sign is the computed tomography finding of multiple pulmonary nodules with central lucency resembling the ring-shaped Cheerio breakfast cereal. Unlike bone metastasis, pulmonary involvement is less common. The Cheerio sign has malignant and benign etiologies. Thyroid transcription factor-1 (TTF-1) stain is commonly used in the diagnosis of primary lung cancer. TTF-1 positivity in cancers of prostate origin is rare, with only case reports and small case series available in the literature. Metastatic prostate cancer presenting with a Cheerio sign has not been reported in the literature.

THE NONCOMPLIANT PATIENT WITH THE BROKEN STENT

THE NONCOMPLIANT PATIENT WITH THE BROKEN STENT

COMBINING REAL-TIME 3-D IMAGING AND AUGMENTED FLUOROSCOPY WITH ROBOTIC BRONCHOSCOPY FOR THE DIAGNOSIS OF PERIPHERAL LUNG NODULES

COMBINING REAL-TIME 3-D IMAGING AND AUGMENTED FLUOROSCOPY WITH ROBOTIC BRONCHOSCOPY FOR THE DIAGNOSIS OF PERIPHERAL LUNG NODULES

S1127 EUS-Guided Gastroenterostomy vs. Enteral Stenting for Palliation of Benign and Malignant Gastric Outlet Obstruction

Introduction: Gastric outlet obstruction (GOO) can occur due to benign or malignant etiologies. Enteral stenting (ES) using self-expanding metal stents has been around for decades and remains a widely used technique in the palliation of GOO. With the advancement of interventional endoscopic ultrasound (EUS) techniques and the advent of lumen-apposing metal stents, EUS-guided gastroenterostomy (EUS-GE) has been adopted as a novel technique for treating symptomatic GOO in benign and malignant etiologies. We conducted a retrospective study to evaluate the outcomes of technical and clinical success and safety in patients with GOO undergoing EUS-GE versus ES. Methods: Patients who underwent EUS-GE or ES for GOO between September 2015 and December 2021 were included in the study. Primary outcomes included technical success defined as successful deployment of the stent and clinical success defined as relief of symptoms and tolerance of oral intake. Secondary outcomes were timing of unplanned re-intervention based on etiology and serious adverse events. Results: A total of 107 procedures among 103 patients met inclusion criteria, 63 (58.9%) underwent ES, and 44 (41.2%) underwent EUS-GE (Table). A higher percentage of malignant etiologies were in the enteral stenting group versus the EUS-GE group (88.9% vs 59.1%, p = 0.0003). Technical success among EUS-GE and ES patients was 100%. Clinical success was achieved by 90.5% of EUS-GE patients compared to 97.7% of ES patients, which was similar in both groups (p = 0.24). There was no significant difference in serious adverse events between EUS-GE and ES patients (3.2% vs 6.8%, p = 0.4). Thirteen ES patients required unplanned re-intervention compared to four EUS-GE patients (20.6% vs 9.1%) but the cumulative incidence functions were not significantly different (p = 0.11). The median time for reintervention in EUS-GE patients was 154 (50,425) days and 94 (43,112) days for ES patients. EUS-GE was associated with a significantly reduced need for unplanned reintervention in an adjusted model for etiology (benign or malignant) (HR: 0.264; 95% CI: 0.086, 0.813; p = 0.02). Conclusion: Technical success, clinical success, and rate of serious adverse events did not significantly differ among EUS-GE and ES patients. However, the rate of unplanned reintervention was significantly lower in the EUS-GE group when adjusted for the etiology of GOO, thus EUS-GE can be considered as a first line therapy for these patients. Table 1. - Summary of Patient Characteristics and Clinical Outcomes Procedures N = 107 Patients N = 103 Enteral Stenting N = 63 EUS-GE N = 44 P-value Age 0.19 Mean (SD) 69.5 (13.2) 65.9 (14.8) Range 38, 95 34, 91 Sex, n (%) 0.64 Male 33 (52.4%) 21 (47.7%) Female 30 (47.6%) 23 (52.3%) Etiology, n (%) 0.0003 Benign 7 (11.1%) 18 (40.9%) Malignant 56 (88.9%) 26 (59.1%) Technical success, n (%) N/A Yes 63 (100.0%) 44 (100.0%) Clinical success, n (%) 0.24 Yes 57 (90.5%) 42 (97.7%) Missing/Unknown 0 1 Serious Adverse event, n (%) 0.4 Yes 2 (3.2%) 3 (6.8%) Unplanned reintervention, n (%) 0.11 Yes 13 (20.6%) 4 (9.1%)

S3618 Gastric Outlet Obstruction as a Presenting Symptom of Duodenal Adenocarcinoma

Introduction: Gastric outlet obstruction (GOO) can be due to benign or malignant causes. Benign etiologies of GOO have been down-trending, resulting in 50-80% of cases of GOO attributable to malignancy. Of the malignant causes leading to GOO, pancreatic adenocarcinoma with extension to the duodenum or stomach is the most common cause, followed by distal gastric cancer. However, primary duodenal adenocarcinoma as the cause of GOO is relatively rare, and we present a case of moderate to poorly differentiated duodenal adenocarcinoma leading to GOO. Case Description/Methods: An 82-year-old man with no reported past medical history presented to the hospital with epigastric abdominal pain associated with worsening distention, nausea, multiple episodes of non-bloody projectile vomiting, and associated weight loss of 12 pounds in the past 2 months. The abdominal exam was unremarkable. Labs were nonsignificant. A computer tomography (CT) scan of the abdomen and pelvis revealed a massively dilated stomach with suspected circumferential narrowing in the distal stomach suggestive of gastric outlet obstruction (Figure A). NGT was placed for decompression, with significant relief of symptoms. The patient underwent EGD, and no gross mass or obstructive etiology was noted in the entire stomach, including pylorus and antrum. There was inflammatory appearing mucosa characterized by extensive edema and contact oozing resulting in mass effect with severe luminal narrowing in the duodenal sweep/D2 regions (Figure B). Biopsies were obtained and showed moderate to poorly differentiated adenocarcinoma (Figure C, D). Subsequently patient underwent palliative duodenal stent placement with symptomatic relief. Discussion: Clinical history is important in suspecting the diagnosis of GOO. Cross-sectional imaging aids in diagnosis but sometimes does not help differentiate benign vs. malignant etiologies. EGD is helpful when imaging is inconclusive and for definitive pathological diagnosis. Most patients achieve symptomatic relief with conservative measures like NPO and NGT decompression. The definitive treatment for GOO varies based on etiology. Most patients with malignant causes need surgery for a cure if suitable candidates. Until recently, surgical gastrojejunostomy was the primary approach for palliative purposes. However, duodenal stent placement has become the primary palliative option as it is a cost-effective, minimally invasive option with adequate symptom relief, shortened hospital stay, and faster resumption of oral intake.Figure 1.: A: CT abdomen/pelvis showed massively dilated stomach with suspected circumferential narrowing in the distal stomach suggestive of gastric outlet obstruction. Circumferential thickening and narrowing of the descending duodenum. B: EGD revealing inflammatory appearing mucosa with extensive edema and contact oozing resulting in mass effect with severe luminal narrowing in the duodenal sweep/D2 regions. C: Immunohistochemistry/histology of biopsies obtained during EGD revealing duodenal adenocarcinoma with tumor glands. D: Tumor emboli in the lymphatics of the duodenal villi.

S1744 Idiopathic Non-Caseating Pancreatic Granuloma Mimicking Neuroendocrine Tumor: A Challenging Diagnostic Dilemma

Introduction: Pancreatic granuloma is rare. Caseating granuloma is usually caused by tuberculosis, while non-caseating granuloma is mainly secondary to systemic diseases such as sarcoidosis, rheumatoid arthritis, fungal infection, and Crohn’s disease. Idiopathic etiology can present a diagnostic challenge, requiring further investigation to differentiate it from malignancy. We present an interesting case of a patient who presented with a concern for a neuroendocrine tumor before diagnosing idiopathic non-caseating pancreatic granuloma. Case Description/Methods: A 75-year-old female presented with left upper quadrant pain, chronic diarrhea, and palpitations. The physical exam was unremarkable. Workup was significant for elevated serum chromogranin 3,123 ng/ml, with mildly elevated urine metanephrines. Magnetic resonance imaging showed a stable 2.5 cm cystic lesion in the tail of the pancreas communicating with the main pancreatic duct and hypointense area in the tail. 68Ga DOTATATE scan was negative for neuroendocrine tumor. Endoscopic ultrasound showed a multi-cystic lesion in the tail of the pancreas with thick septations consistent with branch-duct intrapapillary mucinous neoplasm (BD-IPMN), and a 2.7 cm homogenous well-defined hypoechoic area in the tail of pancreas along with multiple enlarged peripancreatic lymph nodes (Figure). Fine needle biopsy showed multiple non-caseating granulomas with benign pancreatic and lymphoid tissue. There was no evidence of malignancy, and stains for acid-fast bacilli, FITE stain, and fungal cultures were negative. A benign idiopathic etiology was concluded. At the 6-months follow-up, the patient was doing well. Discussion: Non-caseating pancreatic granuloma has been described in a few case reports. Sarcoidosis was the most common cause, followed by rheumatoid arthritis and Crohn’s disease. Other cases were associated with granulomatosis with polyangiitis (formerly Wegener's granulomatosis), xanthogranulomatous disease, insulin-dependent diabetes mellitus, or foreign body (Talc). Patients may present with epigastric pain, sometimes associated with weight loss, jaundice, fever, or nausea. Further workup and sampling, or even surgery, might be necessary before reaching a solid diagnosis and ruling out malignancy. Therefore, it is essential to rule out other etiologies before confirming the diagnosis of idiopathic pancreatic non-caseating granuloma.Figure 1.: Endoscopic ultrasound (EUS) showing a homogenous & well-defined hypoechoic mass in the tail of the pancreas, measuring 11 x 27 mm.

Utility of Fluorine18 Fluoro-2-deoxy-D-glucose Positron Emission Tomography/Computed Tomography in Metabolic Characterization of Solid Renal Mass Lesion and Localization of Extra Renal Lesions in the Body - A Prospective Study from the Tertiary Care Center in South India.

Renal mass lesions in majority of the cases are due to malignant etiology and about one-third of them are reported with metastatic lesions at the time of presentation. Thus proper investigational workup is needed for staging and thereby treatment planning. The current fluorine18 fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (F18-FDG PET/CT) study was designed to characterize renal mass lesions metabolically and identifying other metabolically active lesions in the body suggesting metastatic disease. A total of 24 patients (males - 18 and females - 6) with a mean age of 53.8 ± 12.3 years were recruited in this study for dual time-point PET/CT scan. All patients with renal mass lesions underwent contrast-enhanced CT prior to PET/CT. Metabolic parameters such as maximum standardized uptake value (max.SUV) with a cut off ≥2.5 and retention index (RI) of ≥10% were used to label the lesion as malignant and remaining less than cutoff as benign. The final diagnosis of lesion on imaging was confirmed with a histopathological examination (HPE). Using max.SUV cut off value, 17/24 renal mass lesions were characterized as malignant and remaining 7/24 renal lesions of benign etiology. PET/CT showed sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 80%, 75%, 94.1%, 42.8%, and 79.1%, respectively, by considering HPE as a gold standard. Nine patients were diagnosed with distant site involvement suggestive of metastases. F18-FDG PET/CT can efficiently characterize solid renal mass lesion as benign and malignant using metabolic parameters such as max.SUV and RI. In addition, whole-body survey identified distant site involvement in 25% of the patients, thus contributing change in management.