Renal cell carcinoma chest x ray

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Template:R.H Farima Kahe M.D. [2]

Overview

There are no x-ray findings associated with renal cell carcinoma. However, an x-ray may be helpful in the diagnosis of pulmonary metastasis of renal cell carcinoma.

Chest x ray

There are no x-ray findings associated with renal cell carcinoma. However, an x-ray may be helpful in the diagnosis of pulmonary metastasis of renal cell carcinoma.

The following guidelines of the American Urological Association in 2013 state the following regarding the use of chest xray in renal cell carcinoma:

Use of Chest Xray in Renal Cell Carcinoma

Use of Chest-Xray		Evidence Strength
Low Risk Patient (pT1, N0, Nx)	Yearly chest x-ray to assess for pulmonary metastases for 3 years and only as clinicall indicated beyond that time period	C
Moderate to High Risk Patients (pT2-4N0 Nx or any stage N+)	Chest-xray to be performed every 6 months following a baseline CT or MRI (within 3 to 6 months post-surgery) for at least 3 years and annually thereafter to year 5. Imaging, including chest-xray is warranted by clinical symptoms suggestive of recurrence of metastatic spread. Any imaging, including chest x-ray beyond 5 years may be performed at the discretion of the clinician for moderate to high risk patients	C
Active surveillance	Patients with biopsy-proven renal cell carcinoma or tumor with oncocytic features should undergo an annual chest-xray to assess for pulmonary metastases	C
Patients undergoing ablative procedures with biopy-proven low-risk renal cell carcinoma, oncocytoma, tumor with oncocytic features, non-diagnostic biopsy, or no previous biopsy	Annual chest x-ray for 5 years. Imaging beyond 5 years based on individual patient risk factors and determination of treatment success	Expert opinion

^{Adapted from Donat SM et al. Follow-up for clinically localized renal neoplasms: AUA guideline. J Urol. 2013; 190(2):407-16.}