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Diagnostic imaging of renal tumors of small dimensions
Authors:L Dalla Palma  R Pozzi-Mucelli  S Magnaldi  F Pozzi-Mucelli
Affiliation:Istituto di Radiologia Università Trieste.
Abstract:The incidence of small renal tumors (less than cm 3) has increased in the past few years. Reasons for the increased number of reports are related to the contribution of Sonography and Computed Tomography--which enable a greater number of kidneys to be examined and allow a more detailed study of renal parenchyma. In order to assess the diagnostic value and role of the various imaging techniques in this pathology, the authors reviewed all renal tumors observed between 1982 and 1987. Nineteen cases presented with the characteristics of small renal tumors with "solid" findings on both US and CT. Sixteen cases were histologically proven (15 adenocarcinomas, 1 oncocytoma). Three recent, unoperated, cases are included since their features are the same as in the other cases. Metastases and other kinds of tumors (i.e. angiomyolipomas) are not included in this series. Ivp was performed in 14/19 cases; US and CT were always performed. CT proved to be the most sensitive technique, being positive in all cases. Ivp was positive in 9/14 cases (64%) and US in 14/19 (73%). A significant increase in the number of small renal tumors detected was observed, mainly in 1985-1987. This increase is correlated with the increase in the total number of abdominal examinations which US and CT have made possible. Most patients were asymptomatic; in fact, 15/19 cases were incidentally discovered with US and CT of the upper abdomen. US and CT appear to give a substantial contribution to an early diagnosis of small renal tumors, which may have a significant impact on both surgery and prognosis.
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