BACKGROUND: Renal cell carcinoma (RCC) is an uncommon but noteworthy primary pediatric renal malignancy.
There is a paucity of published data regarding the CT/MRI appearances and accuracy of pretreatment radiologic staging of this form of cancer in children.
OBJECTIVE: To review the various CT/MRI appearances of pediatric RCC and assess the accuracy of pretreatment radiologic staging using these imaging modalities.
MATERIALS AND METHODS: Institutional Departments of Pathology and Radiology records were searched from 1995 through 2010 for children (younger than 18 years of age) with RCC. Available pretreatment contrast-enhanced abdominopelvic CT and MRI examinations were reviewed by two radiologists. Pertinent imaging findings were documented by consensus, and correlation was made between radiologic and surgicopathological TNM staging.
RESULTS: Pretreatment imaging studies from 10 RCCs in nine children (four girls and five boys; mean age 12.9 years) were reviewed. The mean size of the primary tumor was 6.2 cm (range, 1.5-12.6 cm). Ninety percent of RCCs demonstrated heterogeneous postcontrast enhancement. Fifty percent of masses had associated hemorrhage, while 40% contained internal calcification. Regarding TNM staging, N staging was correct for 10 of 10 tumors, while M staging was correct for 10 of 10 tumors. Imaging correctly staged only 4 of 10 tumors with respect to T stage. Radiologic and surgicopathological overall staging were concordant for 8 of 10 tumors.
CONCLUSION: Pediatric RCCs typically present as large, heterogeneous masses, and they commonly hemorrhage and contain internal calcification. Radiologic and surgicopathological overall TNM staging are frequently concordant, although radiologic T staging is often incorrect.
Written by:
Downey RT, Dillman JR, Ladino-Torres MF, McHugh JB, Ehrlich PF, Strouse PJ. Are you the author?
Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.
Reference: Pediatr Radiol. 2012 Apr;42(4):410-7.
doi: 10.1007/s00247-011-2319-5
PubMed Abstract
PMID: 22249598
