CT imaging manifestations of adult nephroblastoma
10.3760/cma.j.cn112330-20230802-00030
- VernacularTitle:成人型肾母细胞瘤的CT影像学表现分析
- Author:
Qian YANG
1
;
Nan CHEN
1
Author Information
1. 华中科技大学同济医学院附属湖北肿瘤医院放射科，武汉 430079
- Publication Type:Journal Article
- Keywords:
Adult;
Kidney tumors;
Nephroblastoma;
Computed tomography
- From:
Chinese Journal of Urology
2025;46(2):87-90
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the CT imaging characteristics of adult Wilms' tumor (WT).Methods:The imaging and clinical data of six patients with adult-onset Wilms tumor (WT) confirmed by pathology were retrospectively analyzed. The cohort consisted of three females and three males, with an average age of (40.12±5.91) years. The clinical manifestations in all cases included abdominal mass and intermittent gross hematuria without obvious inducement. Preoperative enhanced CT examination was performed for all six patients, with a diagnosis of renal malignant tumors in each case. Among the six WT patients, three underwent radical surgery while the remaining three underwent biopsy. Two out of the three surgically treated patients underwent postoperative chemotherapy, while one patient did not undergo chemoradiotherapy at all. As for the biopsy group, two out of the three patients underwent both chemotherapy and radiotherapy, while one patient solely received chemotherapy.Results:Among the 6 lesions, 4 lesions were located in the right kidney, and 2 were located in the left kidney. All of them were single lesions. The maximum diameter of the lesions was 4.2-24.6 cm, and the average diameter was (9.8±5.8)cm. Most part of the tumors were located outside the renal cortex, embedding the kidney as "crescent shap", or "crab foot shap" surrounded the tumor, forming "residual kidney sign" or "marginal sign". All 6 cases had unclear boundaries and uneven density; enhanced CT examination showed mild to moderate and uneven enhancement, and the enhancement degree of the lesions was lower than that of the renal cortex. Twisted and thickened vascular could be seen inside and around the tumor.Conclusions:Normal CT imaging manifestations of Adult WT are large lumps with visible cystic necrosis, while the characteristic signs are tortuous and thickened "wavy" or "noodle like" vascular within and around the tumor. However, the tumor itself lacks blood supply, thus it shows mild uneven enhancement. The lump and residual renal parenchyma show a "crescent shap" change, or "crab foot shap" surrounding the tumor, forming a "residual kidney sign" or "marginal sign" .
