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Case Report

Focal xanthogranulomatous pyelonephritis mimicking adrenal mass: Case report


1 Yalova Devlet Hastanesi Radyoloji Kliniği, Yalova, Türkiye

2 SBÜ Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Radyoloji Kliniği, İstanbul, Türkiye

3 Kocaeli Üniversitesi Radyoloji Anabilimdalı, Kocaeli, Türkiye

4 İstanbul Bilim Üniversitesi Radyoloji Anabilimdalı, İstanbul, Türkiye

5 Başkent Üniversitesi Radyoloji Anabilimdalı, İstanbul, Türkiye

6 İstanbul Bilgi Üniversitesi Radyoloji Anabilimdalı, İstanbul, Türkiye

7 Kocaeli Üniversitesi Genel Cerrahi Anabilimdalı, Kocaeli, Türkiye

8 Kocaeli Üniversitesi Patoloji Anabilimdalı, Kocaeli, Türkiye 

9 Ota Jinemed Hastanesi Üroloji Kliniği, İstanbul, Türkiye


DOI :
New J Urol. 2018; 13 (1): 60-63
Abstract

Abstract

Objective: To review the pathologic fin-dings of a contemporary series of surgically treated renal tumors suspicious for malignancy to assess the frequency of benign disease and treatment modality.

Materials and Methods: The records of 188 patients (120 male, 68 female) underwent sur-gery for suspicious renal mass for malignancy between February 2005 and December 2010 were reviewed retrospectively.

Results: Of 188 cases, records of a total of 178 cases were available for analysis. 142 pati-ents underwent radical nephrectomy (79%), 28 nephron sparing surgery (15%), 4 renal biopsy (3%) and 4 nephroureterectomy (3%). Of 178 tumors, 66 (37%) were discovered incidentally. Forty three (66%) of incidentally diagnosed re-nal masses size  were  less than 7 cm. The pat-hologic evaluation demonstrated malignancy in 156 (88%) and benign disease in 22 (12%). Benign masses were oncocytoma (n=11), an-giomyolipoma (n=6), cystic nephroma (n=2), xanthogranulomatous pyelonephritis (n=2) and metanephric adenoma (n=1). Of 91 renal masses with size of less than 7 cm, 22 (24%) had benign pathology and none of benign masses were bigger than 7 cm.

Conclusion: Inspite of great technological development in the radiological imaging mo-dalities, benign lesions may still be detected pathologically in the patients with preoperative diagnosis of renal cancer. Nephron sparing sur-gery should be kept in mind for the renal mas-ses less than 7 cm, if possible.

Key Words: Benign pathology, renal mass, nephron sparing surgery

Abstract

Objective: To review the pathologic fin-dings of a contemporary series of surgically treated renal tumors suspicious for malignancy to assess the frequency of benign disease and treatment modality.

Materials and Methods: The records of 188 patients (120 male, 68 female) underwent sur-gery for suspicious renal mass for malignancy between February 2005 and December 2010 were reviewed retrospectively.

Results: Of 188 cases, records of a total of 178 cases were available for analysis. 142 pati-ents underwent radical nephrectomy (79%), 28 nephron sparing surgery (15%), 4 renal biopsy (3%) and 4 nephroureterectomy (3%). Of 178 tumors, 66 (37%) were discovered incidentally. Forty three (66%) of incidentally diagnosed re-nal masses size  were  less than 7 cm. The pat-hologic evaluation demonstrated malignancy in 156 (88%) and benign disease in 22 (12%). Benign masses were oncocytoma (n=11), an-giomyolipoma (n=6), cystic nephroma (n=2), xanthogranulomatous pyelonephritis (n=2) and metanephric adenoma (n=1). Of 91 renal masses with size of less than 7 cm, 22 (24%) had benign pathology and none of benign masses were bigger than 7 cm.

Conclusion: Inspite of great technological development in the radiological imaging mo-dalities, benign lesions may still be detected pathologically in the patients with preoperative diagnosis of renal cancer. Nephron sparing sur-gery should be kept in mind for the renal mas-ses less than 7 cm, if possible.

Key Words: Benign pathology, renal mass, nephron sparing surgery

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