Ultrasonography, computed tomography and excretory urography in 25 patients with renal cell carcinoma were reviewed to determine their accuracy in predicting tumor stage. Staging was correct with ultrasonography in 60% of the patients, with computed tomography in 68% and with excretory urography in 40%. There was one patient, in which tumor was not identified on excretory urography. From these results, ultrasonography appears to be a good procedure as computed tomography to evaluate the stage of renal cell carcinomas.
Carcinoma, Renal Cell* ; Humans ; Ultrasonography* ; Urography*

In the 1980s ultrasound and CT gradually replaced angiography as the primary diagnostic modalities for renal masses. From 1983 to 1988, a comparative diagnostic study was carried out on 24 patients with pathologically proven renal cell carcinoma which were staged by various methods. Staging was correct with computerized tomography in 75 per cent of the lesions (15 of 20), with ultrasound in 68.2 per cent (15 of 22) and angiography in 53.8 per cent (7 of 13). We conclude that at the present time CT is the optimal technique to stage renal cell carcinoma. Angiography should be used selected cases not adequately evaluated by CT or ultrasound.
Angiography* ; Carcinoma, Renal Cell* ; Humans ; Ultrasonography*

Cystic renal cell carcinoma represents approximately 15 percent of all renal cell carcinoma. The multilocular cystic renal cell carcinoma is comprised of multiple variable sized. non-communicating, fluid-filled cystic spaces and often extremely difficult to differentiate from non-neoplastic, and other malignant neoplastic masses clinically and radiologically. We have encountered a case of multilocular cystic renal cell carcinoma whose sonographic, computed topographic findings and gross pathologic characteristics were similar to multilocular renal cyst. If multilocular cyst is suspected preoperatively. a more cautious operative approach consisting of in vivo inspection of the lesion and it nessary, frozen section examination of tissue should be followed.
Carcinoma, Renal Cell* ; Frozen Sections ; Kidney Neoplasms ; Ultrasonography

Abdominal ultrasonography was performed in 25,622 adults during the period from July 1992 to June 1995 at the Helth Care Examination Center. The renal masses detected and identified by abdominal sonography were investigated to estimate the incidence of each identification. Renal masses were found in 562 cases(2.19%). Of five hundred and sixty two cases, 555(98.75%) were cystic masses and seven(1.25%) were solid masses. Of five hundred and fifty five cystic masses, 550 were simple cyst(97.86%), four polycystic kindney(0.71%) and one cystic renal cell carcinoma(0.18%). Of seven solid masses, two were angiomyolipoma(0.36%) and another four were renal cell carcinoma(0.71%). The rest one case revealed equivocal finding on an ultrasonography, but the patient refused further study. Although the study population was not a random sampling, the incidence of simple cyst was 2,146 per 100,000 in adult and that of renal cell carcinoma was 19 per 100,000 in adult. Furthermore, ultrasonography is a useful tool for screening the renal carcinoma at the low cost.
Adult ; Carcinoma, Renal Cell ; Humans ; Incidence* ; Mass Screening ; Ultrasonography*

Color Doppler ultrasound imaging( DCI), non-invasive technique, provides the informations of vascular distributions and hemodynamic status, which is helpful to make the differential diagnosis between renal cell carcinoma and benign lesions. We evaluated tumor vascularity, peak systolic velocity, end diastolic velocity, and resistive index(RI) using DCI in 11 cases of renal cell carcinoma and 2 cases of benign lesions. Hypervascularity within the tumor was seen in all patients with renal cell carcinoma. Peak systolic velocity was higher than 3kHz(average 5. 5kHz) in 9 cases. End diastolic velocity was higher than 1kHz(average 2.2kHz) in 9 cases. RI was lower than 0.7(average 0.59) in 9 cases. Arteriovenous shunt was seen in 7 cases. In 4 cases with intermediate mass on CT and USG,' DCI was helpful to make the diagnosis preoperatively. In 2 cases of renal cell carcinoma, DCI was beneficial to evaluate the presence and the extent of tumor thrombi. Whether the hemodynamic parameters could be a prognostic factor needs more cases to be defined.
Carcinoma, Renal Cell* ; Diagnosis ; Diagnosis, Differential ; Hemodynamics ; Humans ; Ultrasonography*

PURPOSE: Recently, incidental small renal tumors detected by computerized tomography(CT) or ultrasonography(US) have been increasing. Differentiation between the small renal cell carcinoma and benign tumorous lesions is often difficult. To reduce the unnecessary surgical interventions for these small renal tumors, we anayzed the radiologic findings of surgically removed small renal tumors(less than 3cm in diameter) and evaluated whether radiologic studies would predict their histologic findings. MATERIALS AND METHODS: Radiologic findings of 28 renal cell carcinomas(RCC), 7 angiomyolipomas(AML), 4 cysts including 2 multilocular cysts and 1 oncocytoma were analyzed, retrospectively. Density, contour, and heterogenity of the tumors on CT were evaluated, while echogenecity, posttumoral enhancement, peritumoral hypoechoic rim, and intratumoral cystic change on US were evaluated. RESULTS: Tiny fat density on CT was found in 4 of 7 AMLs and 1 of 28 RCCs. On US, 3 of 6 AMLs and 1 of 24 RCCs showed marked hyperechogenecity identical to the renal sinus fat. AMLs showed fat density in 4 of 7(57.1%) on CT and marked hyperechogenecity in 5 of 7(71.4%) on US, respectively. Two AMLs which showed hypoechogenecity and no fat density had less than 5% of fat on histologic examination while others had more than 30% of fat. All AMLs, oncocytoma and most RCCs(73%) showed exophytically out-bulging growth pattern while all benign cysts showed endophytic growth. Posttumoral sonic enhancement was found in 3 of 4 cysts and 1 of 24 RCCs. Peritumoral hypoechoic rim and intratumoral cystic changes were identified in 8 of 24(33%) and 7 of 24(29%) RCCs, respectively, while no such findings were detected in other tumors and cysts. CONCLUSIONS: Fat density on CT or marked hyperechogenecity identical to renal sinus fat on US strongly suggest angiomyolipoma, whereas endophytic growth pattern and posttumoral enhancement on US favor benign cyst. In the meantime, absence of above findings combined with peritumoral halo and/or intratumoral cystic change indicate renal cell carcinoma which should be explored.
Adenoma, Oxyphilic ; Angiomyolipoma ; Carcinoma, Renal Cell ; Retrospective Studies* ; Ultrasonography

PURPOSE: Recently, incidental small renal tumors detected by computerized tomography(CT) or ultrasonography(US) have been increasing. Differentiation between the small renal cell carcinoma and benign tumorous lesions is often difficult. To reduce the unnecessary surgical interventions for these small renal tumors, we anayzed the radiologic findings of surgically removed small renal tumors(less than 3cm in diameter) and evaluated whether radiologic studies would predict their histologic findings. MATERIALS AND METHODS: Radiologic findings of 28 renal cell carcinomas(RCC), 7 angiomyolipomas(AML), 4 cysts including 2 multilocular cysts and 1 oncocytoma were analyzed, retrospectively. Density, contour, and heterogenity of the tumors on CT were evaluated, while echogenecity, posttumoral enhancement, peritumoral hypoechoic rim, and intratumoral cystic change on US were evaluated. RESULTS: Tiny fat density on CT was found in 4 of 7 AMLs and 1 of 28 RCCs. On US, 3 of 6 AMLs and 1 of 24 RCCs showed marked hyperechogenecity identical to the renal sinus fat. AMLs showed fat density in 4 of 7(57.1%) on CT and marked hyperechogenecity in 5 of 7(71.4%) on US, respectively. Two AMLs which showed hypoechogenecity and no fat density had less than 5% of fat on histologic examination while others had more than 30% of fat. All AMLs, oncocytoma and most RCCs(73%) showed exophytically out-bulging growth pattern while all benign cysts showed endophytic growth. Posttumoral sonic enhancement was found in 3 of 4 cysts and 1 of 24 RCCs. Peritumoral hypoechoic rim and intratumoral cystic changes were identified in 8 of 24(33%) and 7 of 24(29%) RCCs, respectively, while no such findings were detected in other tumors and cysts. CONCLUSIONS: Fat density on CT or marked hyperechogenecity identical to renal sinus fat on US strongly suggest angiomyolipoma, whereas endophytic growth pattern and posttumoral enhancement on US favor benign cyst. In the meantime, absence of above findings combined with peritumoral halo and/or intratumoral cystic change indicate renal cell carcinoma which should be explored.
Adenoma, Oxyphilic ; Angiomyolipoma ; Carcinoma, Renal Cell ; Retrospective Studies* ; Ultrasonography

The diagnostic significance of ultrasonography, computed tomography and magnetic resonance imaging for predicting the stage of tumors was evaluated by comparing their results with preoperative and histopathologic findings. The 24 patients who were diagnosed as renal cell carcinoma by histopathologic finding have taken preoperative examination such as ultrasonography, computed tomography. Additionally, magnetic resonance imaging was performed in 15 patients among them. The T stage was determined correctly by magnetic resonance imaging in 87% of the cases, by computed tomography in 80%. We suggested that a computed tomography is reliable imaging method for evaluating the T,N category preoperatively, but magnetic resonance imaging is more sensitive than a computed tomography in predicting the stage of renal cell carcinoma and a magnetic resonance imaging can replace the computed tomography.
Carcinoma, Renal Cell* ; Humans ; Magnetic Resonance Imaging ; Ultrasonography

PURPOSE: The aim of this study was to explore the usefulness of the resistive index (RI) on spectral Doppler ultrasonography (US) in the detection of renal cell carcinoma (RCC) in patients with end-stage renal disease (ESRD). METHODS: Seventeen ESRD patients with kidneys in which renal masses were suspected in routine US were subjected. They underwent computed tomography scans and additional Doppler US for the characterization of the detected lesions. All underwent radical nephrectomy with the suspicion of RCC. Fourteen patients finally were included. RI measurements were conducted in the region of the suspected renal mass and the background renal parenchyma. The intraclass correlation coefficient was used to assess the reproducibility of the RI measurement. A paired t-test was used to compare the RI values between the renal mass and the background renal parenchyma (P<0.05). RESULTS: The RI values measured at the RCCs were significantly lower than those measured at the background renal parenchyma (0.41-0.65 vs. 0.75-0.89; P<0.001). The intrareader reproducibility proved to be excellent and good for the renal masses and the parenchyma, respectively (P<0.001). CONCLUSION: RI on spectral Doppler US is useful in detecting RCC in patients with ESRD. The RI values measured at the RCCs were significantly lower than those measured at the background renal parenchyma.
Carcinoma, Renal Cell* ; Humans ; Kidney ; Kidney Failure, Chronic* ; Nephrectomy ; Ultrasonography, Doppler* ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Pulsed

The congenital absence of an inferior vena cava is an uncommon abnormality. With the advent of modern imaging techniques, such cases are being found with increasing frequency. Here we report a case of a renal cell carcinoma with the absence of an inferior vena cava in a 44 year-old male. He was referred for a further evaluation of a right renal mass, which was observed by ultrasonography, and for persistent epigastric discomfort. Computed tomography showed a huge mass in the right kidney and multicystic lesions in the left. In addition, the inferior vena cava had disappeared at the infrahepatic portion. He was treated with a right radical nephrectomy.
Adult ; Carcinoma, Renal Cell* ; Humans ; Kidney ; Male ; Nephrectomy ; Ultrasonography ; Vena Cava, Inferior*