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Angiomyolipoma and renal cell carcinoma: US differentiation
C L Siegel1, W D Middleton, S A Teefey
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri 63110, USA.
Radiology
|March 1, 1996
Summary
Shadowing on ultrasound is a key feature that helps differentiate angiomyolipoma (AML) from renal cell carcinoma (RCC). Other features like hypoechoic rims and intratumoral cysts also aid in distinguishing these renal masses.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Differentiating renal angiomyolipoma (AML) from renal cell carcinoma (RCC) is crucial for appropriate patient management.
- Ultrasound (US) is a primary imaging modality for evaluating renal masses.
Purpose of the Study:
- To determine the utility of ultrasound (US) features, specifically shadowing, in distinguishing renal angiomyolipoma (AML) from renal cell carcinoma (RCC).
Main Methods:
- Retrospective review of US images from 49 patients with RCC and 35 patients with AML.
- Evaluation of tumor characteristics including size, location, echogenicity, homogeneity, shadowing, hypoechoic rim, and intratumoral cysts.
- Analysis of CT scans for fat and soft tissue content in AMLs when available.
Main Results:
- Angiomyolipomas (AMLs) were generally smaller and more echogenic than renal cell carcinomas (RCCs), with significant overlap.
- Shadowing was observed in 33% of AMLs but not in any RCCs.
- Hypoechoic rims and intratumoral cysts were exclusively found in RCCs.
Conclusions:
- Shadowing on ultrasound is a significant indicator that helps differentiate angiomyolipoma (AML) from renal cell carcinoma (RCC).
- The presence of a hypoechoic rim and intratumoral cysts on ultrasound are important findings suggestive of renal cell carcinoma (RCC).
- These US features are valuable for distinguishing hyperechoic renal masses.