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Simple renal cysts in children: diagnosis and follow-up with US
K McHugh1, D A Stringer, D Hebert
1Department of Radiology, Hospital for Sick Children, Toronto, Ont, Canada.
Insights
Simple renal cysts are uncommon in children, found in 0.22% of cases. These pediatric renal cysts typically do not require intervention if kidney function is normal.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging
- Renal Ultrasound
Background:
- Simple renal cysts are incidental findings in pediatric abdominal sonography.
- Understanding the prevalence and natural history of these cysts is important for clinical management.
Purpose of the Study:
- To determine the sonographic frequency of simple renal cysts in a pediatric population.
- To evaluate the behavior and outcomes of simple renal cysts in children.
Main Methods:
- Retrospective review of abdominal sonograms from 16,102 children over a 5-year period.
- Exclusion of patients with abnormal renal function, kidney dysplasia, or family history of polycystic kidney disease.
- Analysis of cyst characteristics, distribution, and follow-up sonographic data.
Main Results:
- A prevalence of 0.22% (37 cysts in 35 patients) was identified.
- Cysts ranged from 0.3 to 7.0 cm, with a predilection for the right upper pole.
- Follow-up showed stability in 74% of cysts; no renal function deterioration was observed.
Conclusions:
- Simple renal cysts are rare in children with normal renal function.
- Conservative management is appropriate for asymptomatic simple renal cysts in pediatric patients.
- No further intervention is typically needed for incidentally discovered simple renal cysts in children with normal renal function.
Abstract:
To assess the sonographic frequency of simple renal cysts in children, the authors retrospectively reviewed the results of abdominal sonographic studies of 16,102 children performed over a 5-year period between January 1, 1985, and December 31, 1989. Patients with abnormal renal function, dysplastic kidneys, or a family history of polycystic kidney disease were excluded from the study. The authors' review of the sonograms revealed 37 simple cysts in 35 patients (0.22%); the cysts were evenly distributed by age and sex and measured from 0.3 to 7.0 cm in maximum diameter. Sixteen cysts (43%) were in the upper pole of the right kidney. Follow-up sonographic studies of 23 cysts in 22 patients for up to 5 years showed no change in size in 17 cysts (74%). The largest cyst was drained percutaneously; all other cysts were managed conservatively. No patient showed deterioration of renal function. Therefore, the authors concluded that in a pediatric patient demonstrating normal renal function, no further intervention is necessary when a simple renal cyst is identified at sonography.