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KMID : 0377619770330050489
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Korean Jungang Medical Journal
1977 Volume.33 No. 5 p.489 ~ p.493
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A Case of Avascular Renal Adenocarcinoma
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Abstract
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A case of unusual avascular renal adenocarcinoma is reported.
With reference to the literature, such avascular renal tumor have been thought to be attached to the type of papillary-tubular adenocarcinoma of the kidney. Since dos Santos introduced translumbar aortography in 1929, the place of renal arteriography in the diagnosis and management of patients with suspected renal masses has been the subject of controversy. But the advent of the selective renal angiography prompted a reappraisal of the role of arteriography in the diagnosis of renal lesions. As experience with this new method increased, however, it became evident that the angiographic appearances of renal adenomas, hamartomas, and inflammatory processes might be confused with those of cysts and malignant tumors, and that renal-cell carcinoma might be mistakenly diagnosed as a benign lesion.
Despite this limitations, selective renal angiography is thought to be the choice of radiological tool with 95% to 99% accuracy in differential diagnosis of renal masses. With several adjunctive studies such as conventional urograms, nephrotom-ogram, ultrasonogram, and percutaneous puncture of suspected renal cyst, danger off misdiagnosis is avoided almost completely even in the case of avascular renal cell carcinoma.
About 6% of renal adenocarcinomas, especially papillary-tubular type, show atypical avascularity in selective renal angiography. But some physicians reported that primary renal tumors of a variety of histopathologic cell type might be angiographically avascular such as this 1 case.
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