Renal oncocytoma overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2] Shanshan Cen, M.D. [3]
Overview
Renal oncocytoma is a relatively rare and benign tumor. On gross pathology, tan or mahogany brown, well circumscribed tumor, and central scar are characteristic findings of renal oncocytoma. On microscopic histopathological analysis, oncocytes and large eosinophilic cells are characteristic findings of renal oncocytoma.[1] Renal oncocytoma must be differentiated from renal cell carcinoma, metanephric neoplasms, and renal leiomyoma. The incidence of renal oncocytoma increases with age; the median age at diagnosis is 55 years. The male to female ratio is approximately 2 to 1.[2] Symptoms of renal oncocytoma include hematuria and flank pain. Abdonimal CT scan, ultrasound, and intravenous pyelogram may be helpful in the diagnosis of renal oncocytoma. Surgery is the mainstay of treatment for renal oncocytoma. Prognosis is generally excellent.[3]
Historical perspective
Renal oncocytoma was first discovered by Zippel, in 1942 and Klein and Valensi were the first to demonstrate the pathologic characteristics of renal oncocytoma as “proximal tubular adenoma with oncocytic features” in 1976.
Classification
There is no established system for the classification of renal oncocytoma.
Pathophysiology
On gross pathology, tan or mahogany brown, well circumscribed tumor, and central scar are characteristic findings of renal oncocytoma. On microscopic histopathological analysis, oncocytes and large eosinophilic cells are characteristic findings of renal oncocytoma.[1]
Causes
There are no established causes for renal oncocytoma.
Differential Diagnosis
Renal oncocytoma must be differentiated from other diseases that cause abdominal mass, abdominal pain and hematuria such as wilms tumor, renal cell carcinoma, rhabdoid kidney disease, polycystic kidney disease, and other urogenital mass.
Epidemiology and Demographics
The incidence of renal oncocytoma is approximately 3% to 7% of solid renal resected tumors. Patients of all age groups may develop renal oncocytoma. The age of patients can be differ from 10 to 94 years. The incidence of renal oncocytoma increases with age; the median age at the time of surgery is 62 to 68 years. Males are more commonly affected by renal oncocytoma than females. The male to female ratio is approximately 2 to 1.
Risk Fctors
There are no established risk factors for renal oncocytoma.
Screening
There is insufficient evidence to recommend routine screening for renal oncocytoma.
Prognosis
Prognosis is generally excellent.[3]
Staging
There is no established system for the staging of reanl oncocytoma.
Diagnosis
History and Symptoms
The majority of patients with renal oncocytoma are asymptomatic. Symptoms are seen in almost only 17% to 21% of patients with renal oncocytoma. Symptoms of renal oncocytoma include hematuria, flank pain, abdominal or flank mass and weight loss.
Physical Examination
Physical examination of patients with renal oncocytoma is usually normal. An abdominal or flank mass may be palpayed during physical examination.
Laboratory Findings
Some patients with renal oncocytoma may have hematuria, in their urine analysis.
X Ray
X-ray is rarely done for the diagnosis of renal oncocytoma.
CT Scan
Abdonimal CT scan is helpful in the diagnosis of renal oncocytoma.
MRI
MRI may be helpful in the diagnosis of renal oncocytoma.
Ultrasound
Renal ultrasound in renal oncocytoma patients may show: solid mass ( help to distinguish solid from cystic mass), central scarring, calcification, central necrosis which none of them characteristics for indicating a specific renal lesion.
Other Imaging Findings
Intravenous pyelogram may be helpful in the diagnosis of renal oncocytoma.
Other Diagnostic Studies
There are no other diagnostic study findings associated with renal oncocytoma.
Treatment
Medical Therapy
The mainstay of therapy for renal oncocytoma is surgery.
Surgery
Surgery is the mainstay of treatment for renal oncocytoma.
Primary Prevention
There is no established method for prevention of renal oncocytoma.
Secondary Prevention
There are no secondary preventive measures available for renal oncocytoma.
References
- ↑ 1.0 1.1 Palmer WE, Chew FS (1991). "Renal oncocytoma". AJR Am J Roentgenol. 156 (6): 1144. doi:10.2214/ajr.156.6.2028856. PMID 2028856.
- ↑ Renal oncocytoma.Dr Donna D'Souza et al. Radiopaedia.org 2015.http://radiopaedia.org/articles/renal-oncocytoma
- ↑ 3.0 3.1 Lieber MM (1990). "Renal oncocytoma: prognosis and treatment". European Urology. 18 Suppl 2: 17–21. PMID 2226597.