Renal Neoplasms in Young Adults
Prasaanthan Gopee-Ramanan1, Sook Suzy Chin1, Chris Lim1
1From the Department of Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, 200 Elizabeth St, Toronto, ON, Canada M5G 2C4 (P.G.R., S.S.C., S.K.); Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont, Canada (C.L.); Department of Radiology, NYU Langone Medical Center, New York, NY (K.P.S.); and Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont, Canada (N.S.).
Renal cell carcinoma (RCC) in young adults presents differently than in older adults, often with better survival. Genetic testing is crucial for identifying familial syndromes that influence diagnosis and treatment.
Area of Science:
- Oncology
- Radiology
- Genetics
Background:
- Renal cell carcinoma (RCC) is typically diagnosed in older adults, with a median age of 64.
- RCC in patients younger than 45 years exhibits distinct clinical, pathological, and prognostic features.
- Familial renal neoplastic syndromes are more prevalent in young adults with RCC, necessitating genetic testing.
Purpose of the Study:
- To highlight the unique epidemiological, imaging, and pathological characteristics of RCC in young adults.
- To discuss the management, surveillance, and treatment nuances for renal neoplasms in this demographic.
- To emphasize the radiologist's role in the multidisciplinary care of young adults with RCC.
Main Methods:
- Pictorial review of syndromic, nonsyndromic, and newer RCC entities common in young adults.
- Discussion of associated epidemiology, imaging findings, and pathological traits.
- Analysis of surveillance and management strategies tailored to young adults.
Main Results:
- RCCs in young adults are often smaller, organ-confined, and diagnosed at earlier stages.
- Clear cell RCC is less common, while familial syndromes are more frequent, sometimes involving malignant cysts.
- Young adults generally experience better disease-specific survival after surgical treatment, with a preference for nephron-sparing approaches.
Conclusions:
- Radiologists must recognize the distinct features of RCC in young adults and adapt diagnostic and management approaches.
- Treatment and surveillance strategies are influenced by the presence and type of underlying familial renal neoplastic syndrome.
- Informed radiologists are vital for the multidisciplinary management of RCC in young adults.
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