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Incidental neoplasms in renal biopsies
Tanya Pankhurst1, Alexander J Howie, Dwomoa Adu
1Department of Nephrology, University Hospital Birmingham, Birmingham B15 2TH, UK.
Summary
Incidental renal neoplasms found in biopsies require pathological typing and imaging. Surgery is recommended for detectable lesions, while undetectable ones may need surveillance, though its necessity is undetermined.
Area of Science:
- Nephrology
- Oncology
- Pathology
Background:
- Incidental neoplastic lesions are occasionally discovered in renal biopsy specimens.
- Current evidence lacks clear guidelines for managing these incidental renal neoplasms.
Purpose of the Study:
- To review the management and clinical outcomes of patients with unsuspected neoplasms found during renal biopsy.
- To establish potential management strategies for incidental renal neoplasms.
Main Methods:
- Retrospective review of patient management and clinical course.
- Analysis of 11,880 renal biopsies over 22 years.
- Pathological classification and imaging (CT, MRI, ultrasound) of identified neoplasms.
Main Results:
- 25 incidental neoplasms (0.2%) were found in 11,880 biopsies.
- Most neoplasms were papillary (22), with two clear cell renal carcinomas and one in situ carcinoma.
- Surgical resection was performed for detectable or aggressive neoplasms; surveillance was used for undetectable lesions.
Conclusions:
- Pathological type and imaging are crucial for managing incidental renal neoplasms.
- Surgical resection, including partial nephrectomy, is considered for imaging-detectable neoplasms.
- Management of imaging-undetectable neoplasms, especially in renal allografts, requires further investigation, with surveillance suggested.