Renal cell carcinoma has a wide and varied spectrum of symptoms and signs, which are separable into local tumor effect, metastatic symptoms and extrarenal manifestations. Therefore, for the urologist diagnosis of renal cell carcinoma can be difficult to be made even after complete evaluations. We report three cases of unusual presentations of renal cell carcinoma confirmed by exploration and microscopic examination.
Carcinoma, Renal Cell* ; Diagnosis

PURPOSE: It may be difficult to differentiate renal cell carcinoma involving collecting system from renal urothelial tumor invading into renal parenchyma. The purpose of this study was to assess the differences of CT findings between two conditions. MATERIALS AND METHODS: CT findings of 5 cases of renal cell carcinoma involving the renal collecting systems and 10 cases of renal urothelial tumors invading the renal parenchyma were compared, and analyzed about the presence or absence of hydronephrosis, normal or abnormal CT nephrogram, renal contour changes due to mass and tentative diagnosis. The diagnoses were confirmed at surgery. RESULTS: Renal cell carcinoma showed hydronephrosis in only 20% and normal CT nephrogram and outward contour bulging in all cases. In contrast, renal urothelial tumor showed hydronephrosis(70%), abnormal CT nephrogram(60%), and preservation of reniform shape(100%). CONCLUSION: Renal contour changes and CT nephrogram may be useful in distinguishing both disease entities.
Carcinoma, Renal Cell* ; Diagnosis ; Hydronephrosis

PURPOSE: To find the CT and US findings of multilocular cystic renal cell carcinoma. MATERIAL AND METHODS: We retrospectively analysed CT and US findings of five cases of the pathologically proven multilocular cystic renal cell carcinoma. We analysed CT and US with view points of tumor margin, growth pattern, renal contour change, echogenicity, attenuation on pre- and postcontrast scan, thickness and number of septum, and perirenal change. RESULTS: The CT findings of the multilocular cystic renal cell carcinoma were large well defined round encapsulated multiple fluid filled cystic mass with exophytic growing pattern. The capsule and septum were relatively well enhanced with contrast medium. The cystic space and septurn were variable in size and shape. US revealed large multiple fluid filled cystic mass separated by echogenic septum. CONCLUSION: The above CT and US findings of multilocular cystic renal cell carcinoma may be helpful in the diagnosis.
Carcinoma, Renal Cell* ; Diagnosis ; Retrospective Studies

PURPOSE: To evaluate US and CT characteristics of small renal cell carcinomas with diameter less than 3cm. MATERIALS AND METHODS: We retrospectively analysed US and CT findings of the small renal cell carcinomas which were surgically confirmed. We analysed echogenicity, peritumoral hypoechoic rim, intratumoral cysts on US. We analysed CT with viewpoints of tumor margin, growth pattern, renal contour change, attenuation on pre- and postcontrast scan, homogeneity, and perirenal changes. RESULTS: The US characteristics of the small renal cell carcinomas were hyperechogenicity(89%), peritumoral hypoechoic rim(66%) and intratumoral cysts(44%). They had relatively well-defined margin(90%), smooth and round contour(90%), endophytic growth pattern(65%), and outward bulging of renal contour(75%) on CT. They had iso- or high attenuation(87%) on precontrast CT, and were relatively homogeneous low-attenuated on postcontrast CT. CONCLUSION: The constellation of US and CT findings may be helpful in the diagnosis and understanding of the internal architecture of the small renal cell carcinomas.
Carcinoma, Renal Cell* ; Diagnosis ; Retrospective Studies

Urine cytology is of limited value in the diagnosis of renal cell carcinoma with reported detection rates of 0~80%. The aim of this study is to demonstrate the usefulness of urine cytology in renal cell carcinoma, In the eleven histologically proven cases of renal cell carcinoma, urinary smears were reevaluated. The cytologic results were as follows; positive for malignant cells in 3 cases (27%), suspicious in 2 cases (18%) and negative in 6 cases (55%). The average diameter of the tumor of the 5 cases reported as positive or suspicious for malignant cells was 9.7cm and 3 had invaded the renal pelvis. The other 6 tumors, reported as negative, were 5.7cm in average diameter and one of them showed involvement of the renal pelvis. These results suggest that urine cytology is considered unsatisfactory in the early detection of renal cell carcinoma. However. careful examination of urinary smear could improye the detection rate especially in more advanced cases involving the renal pelvis as well as those of larger tumors.
Carcinoma, Renal Cell* ; Diagnosis ; Kidney Pelvis

Renal angiogram is a safe and excellent procedure for an early detection and accurate diagnosis of benign or malignant diseases. Selective renal angiography has been used mainly in the diagnosis of surgical disease, but now many informations are available regarding the vascular disease, pyelonephritis and renal tuberculosis. A clinical observation was made on 18 cases of the renal angiography from January. 1978 to June, 1981.
Angiography* ; Carcinoma, Renal Cell ; Diagnosis ; Pyelonephritis ; Tuberculosis, Renal ; Vascular Diseases

PURPOSE: To assess the utility of multiphasic spiral CT for characterizing renal masses. MATERIALS AND METHODS: The study included 36 patients (53 lesions) referred for the evaluation of renal masses suspected on the basis of the results of sonography or radiography. Spiral CT of the kidneys was performed prior to and following power injection of intravenous contrast material (Optiray-320). Postcontrast imaging data were obtained and analyzed during early and late corticomedullary (20-30-second delay), nephrographic (60-70-second delay), and excretory (5-minute delay) phases. During each phase, the ability to detect renal masses was evaluated, and the ability to diagnose these masses on routine and multiphasic CT was assessed. Routine precontrast and excretory phase CT studies were performed and the usefulness of each phase for the diagnosis of renal cell carcinoma (RCC) and transitional cell carcinoma (TCC) was evaluated. RESULTS: The rates for the detection of renal masses were as follows: 94.3% on precontrast scan, 93.8% during the early corticomedulolary phase (ECMP), 98.1% during the late corticomedullary phase (LCMP), 100% during the nephrographic phase (NP), and 98.1% during the excretory phase (EP). During both routine and multiphasic CT, diagnostic accuracy was 96.2%, though for differential diagnosis, multiphasic CT was more helpful than routine CT in 4/16 cases of RCC and 2/8 cases of TCC. The highest for lesion characterization, during the LCMP in RCC, and the LCMP and NP in TCC ; for evaluation of tumor margin during the EP in both RCC and TCC ; for delineation of the renal artery, during the LCMP in both RCC and TCC ; for delineating the renal vein, during the NP in RCC, and the LCMP in TCC. CONCLUSION: For the detection and correct diagnosis oflesions, multiphasic CT was not superior to routine CT, but for the characterization of RCC and TCC, the former was helpful. The most useful phase can differ according to the kind of renal mass, and so for characterization of the mass, the most appropriate phase must be selected.
Carcinoma, Renal Cell ; Carcinoma, Transitional Cell ; Diagnosis ; Diagnosis, Differential ; Humans ; Kidney ; Radiography ; Renal Artery ; Renal Veins ; Tomography, Spiral Computed*

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*

Periadrenal retroperitoneal tumors are frequently misdiagnosed as adrenal tumors because of its rarity and anatomical vicinity. Thus, there are only very few cases reported and little information available in the literature. Preoperative diagnoses of theses tumors are challenging. The definitive diagnosis is based on postoperative pathological findings. We report two cases of periadrenal retroperitoneal tumors that mimicked adrenal neoplasms. Final diagnoses were mature cystic teratoma and papillary renal carcinoma, respectively. Although periadrenal retroperitoneal tumors are rare, it should be considered in the differential diagnosis of adrenal incidentalomas.
Adrenal Gland Neoplasms ; Carcinoma, Renal Cell ; Diagnosis ; Diagnosis, Differential ; Teratoma

Cases of sarcomatoid renal cell carcinoma are very rare. It has been known that sarcomatoid renal cell carcinoma is an epithelial cell variant that has been metaplastically transformed with a very poor prognosis. Diagnosis of sarcomatoid renal cell carcinoma is performed by examining a nephrectomy specimen to see if epithelial and sarcomatoid components are variously mixed together. Therefore, the aim of this paper is to report five cases of sarcomatoid renal cell carcinoma.
Carcinoma, Renal Cell* ; Diagnosis ; Epithelial Cells ; Nephrectomy ; Pathology ; Prognosis