Source of diagnostic pitfalls in renal sonography

Area of Science:

• Nephrology
• Radiology
• Urology

Background:

• Renal mass evaluation is crucial for diagnosis and treatment.
• Ultrasound is a primary imaging modality for renal masses.
• Differentiating cystic from solid renal masses impacts management.

Observation:

• 116 renal masses were evaluated.
• 91 (80%) were initially interpreted as cystic.
• 25 (20%) were initially interpreted as solid.

Findings:

• Further evaluation revealed 3 of 25 solid masses were actually cystic.
• These misidentified masses were complex cystic structures with internal echoes.
• Surgical findings indicated collections of contiguous or loculated cysts with calcification.

Implications:

• Internal echoes on ultrasound can indicate complex cystic renal masses.
• Calcification within cystic renal masses can mimic solid components.
• These findings represent diagnostic pitfalls in renal sonography, potentially altering patient management.