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Updated: Nov 15, 2025
09:31
In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
Published on: March 30, 2015
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Macroscopic fat containing renal cell carcinoma
Maria Kirkinis1, Tom Sutherland1,2
1Department of Medical Imaging, St Vincent's Hospital, Melbourne, Victoria, Australia.
Journal of Medical Imaging and Radiation Oncology
|March 5, 2021
Summary
Macroscopic fat in renal masses typically indicates benign angiomyolipoma. However, two cases of renal cell carcinoma presented with fat, challenging this diagnostic rule and altering clinical approaches for such lesions.
Area of Science:
- Urology
- Oncology
- Radiology
Background:
- Macroscopic fat in renal masses is historically pathognomonic for angiomyolipoma, a benign tumor.
- This presentation details two atypical cases that challenge this established diagnostic axiom.
Discussion:
- The first case was initially considered for angioembolisation but was later biopsied due to being angiographically occult.
- The second case exhibited a small macroscopic fat component and arterial enhancement, necessitating a biopsy.
- Neither case showed calcifications, which often suggest a more malignant lesion.
Key Insights:
- Both atypical renal masses were diagnosed as renal cell carcinoma.
- These findings highlight that macroscopic fat does not exclusively indicate benign angiomyolipoma.
Outlook:
- The multidisciplinary approach to managing renal masses with macroscopic fat and no calcifications has been revised.
- Further investigation is warranted for renal masses with atypical fat components.
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