[Diagnostic and therapeutic characteristics of the preoperatively misclassified complicated renal cysts].

ABSTRACT

OBJECTIVE: To explore the clinical features and treatment options of patients undergoing surgical masses excision for preoperatively misclassified complicated renal cysts. METHODS: Retrospective analysis was performed on clinical records of patients who received partial or radical nephrectomy at Department of Urology of Peking Union Medical College Hospital with postoperatively pathological examination as benign renal cysts from January 2008 to December 2014. RESULTS: There were a total of 31 patients meeting the inclusion criteria for analysis. Among them 4 patients were classified as Bosniak II renal cysts by preoperative ultrasonography and/or computed tomography (CT), 7 patients as Bosniak IIF and III respectively, 3 patients as Bosniak IV, as well as 10 patients as renal solid masses. The average max diameter of the lesions was 3.34 ± 2.45 cm (ranging from 0.8 cm to 14.3 cm), with 83.87% lesions less than 4 cm. Eighteen patients (58.06%) received open partial nephrectomy, while 13 patients underwent laparoscopic partial or radical nephrectomy. CONCLUSIONS: A considerable number of patients received unnecessary partial or even radical nephrectomy for misclassified benign renal cysts. Small high-density renal cysts could not only mimic solid renal masses on ultrasonography and plain CT, but also present pseudoenhancement on enhanced CT, thus easily leading to a misdiagnosis as solid renal tumors.