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Differential diagnosis of complex renal cysts based on lesion size along with the Bosniak renal cyst classification

 Hyun Ho Han  ;  Kyung Hwa Choi  ;  Young Taik Oh  ;  Seung Choul Yang  ;  Woong Kyu Han 
 YONSEI MEDICAL JOURNAL, Vol.53(4) : 729-733, 2012 
Journal Title
Issue Date
Adolescent ; Adult ; Age Factors ; Aged ; Carcinoma, Renal Cell/diagnosis ; Carcinoma, Renal Cell/diagnostic imaging ; Child ; Child, Preschool ; Diagnosis, Differential* ; Female ; Humans ; Infant ; Kidney Diseases, Cystic/diagnosis* ; Kidney Diseases, Cystic/diagnostic imaging ; Kidney Neoplasms/diagnosis* ; Kidney Neoplasms/diagnostic imaging ; Male ; Middle Aged ; Sex Factors ; Tomography, X-Ray Computed ; Young Adult
Kidney ; cysts ; kidney diseases ; cystic ; carcinoma ; renal cell ; computed tomography ; X-ray
PURPOSE: To identify size criteria for complex cystic renal masses that can distinguish renal cell carcinoma from benign cysts supplementing the Bosniak classification. MATERIALS AND METHODS: We reviewed the records of 97 patients who underwent surgery for complex cystic renal masses from January 2001 to April 2010. The pathological results were compared with the lesion sizes measured by preoperative computed tomography and other radiological features (contrast enhancement, irregularities of cyst walls and septa, and calcification) were also obtained for categorization according to the Bosniak renal cyst classification. RESULTS: Malignancy was significantly associated with cyst size (>2 cm), male gender, and younger patient age (<50 years). According to the Bosniak classification, there was no category I cyst, and all 8 category II cysts were benign. However, 3 of 18 (17%) category IIF cysts, 21 of 39 (54%) category III cysts, and 29 of 32 (90%) category IV cysts were malignant. All category IIF cysts were benign in patients older than 50 years of age. CONCLUSION: Many complex cystic renal masses smaller than 2 cm were benign. We suggest that lesion size should be taken into account when formulating treatment plans for complex cystic renal masses.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Yang, Seung Choul(양승철)
Oh, Young Taik(오영택) ORCID logo https://orcid.org/0000-0002-4438-8890
Choi, Kyung Hwa(최경화)
Han, Woong Kyu(한웅규) ORCID logo https://orcid.org/0000-0002-2527-4046
Han, Hyun Ho(한현호) ORCID logo https://orcid.org/0000-0002-6268-0860
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