Fat-filled postoperative renal cortical defects: sonographic and CT appearance

Area of Science:

• Nephrology
• Radiology
• Surgical Pathology

Background:

• Renal cortical wedge resections are surgical procedures to address specific kidney pathologies.
• Postoperative changes can sometimes present diagnostic challenges in medical imaging.
• Distinguishing benign postoperative findings from neoplastic lesions is critical for patient management.

Purpose of the Study:

• To describe the imaging characteristics of renal defects filled with vascularized retroperitoneal fat.
• To highlight the potential for these findings to be mistaken for focal renal masses.
• To emphasize the importance of correct identification to avoid unnecessary workup for renal neoplasm.

Main Methods:

• Retrospective analysis of four patients who underwent surgical filling of renal cortical defects.
• Review of postoperative sonographic and computed tomography (CT) imaging findings.
• Correlation of imaging findings with clinical information and surgical procedures.

Main Results:

• Postoperative imaging (ultrasound and CT) in four patients demonstrated appearances simulating focal renal masses.
• The simulated masses were attributed to the use of vascularized retroperitoneal fat for defect filling.
• These findings underscore a potential imaging pitfall in the postoperative renal setting.

Conclusions:

• Surgical filling of renal cortical defects with retroperitoneal fat can lead to imaging findings mimicking renal masses.
• Radiologists and clinicians must be aware of this potential pitfall to avoid misdiagnosis.
• Correct identification prevents unnecessary further evaluation for suspected renal neoplasm.