CYSTIC RENAL-CELL CARCINOMA - RADIOLOGICAL FEATURES AND CLINICOPATHOLOGICAL CORRELATION

The radiological appearances of 11 cystic renal cell carcinomas (RCC) presenting over a 13-year-period are reviewed and correlated with thei r clinicopathological features, The tumours occurred in seven males an d four females with a mean age of 59.1 years (range 27-87 years), Thei r ultrasound features mere categorized according to Bosniak [5], There were six category 3 or 4 cysts (indeterminate or malignant); three ca tegory 2 cysts and two category 1 cysts, Computed tomography scans (CT ) demonstrated malignant features in all seven patients scanned, Cyst aspiration, intravenous urograms and arteriograms were generally unhel pful, Histological growth patterns of nine tumours were determined and all were staged by Robson's classification: eight were Stage 1, one w as Stage 3 and two were Stage 4, Three of four deaths were related to tumour bulk, and the fourth patient died from an unrelated cause, All seven survivors had Stage 1 disease, No correlation existed between di fferent histological subtypes and tumour aggression, Overall, the beha viour of cystic RCCs was similar to those of solid RCCs apart from the high percentage (72.2%) of Stage 1 disease, We conclude that any devi ation from a simple cyst on ultrasound should be assessed by CT and/or surgery, Indeterminate lesions on CT including multilocular lesions s hould be surgically explored.