Utilization of fine-needle aspiration in the diagnosis of metastatic tumors to the kidney

Renal masses secondary to metastases are not common. Few comprehensive revi ews exist, which consist primarily of autopsy and radiologic reports. The p urpose of this study was to review the types and incidences of various neop lasms which metastasize to the kidney and to determine the usefulness of fi ne-needle aspiration (FNA) in diagnosing them. Two hundred and sixty-one ra diologically guided FNAs of renal lesions over a 9-yr period were reviewed The diagnoses of the 261 renal FNAs were as follows: 136 (52%) were maligna nt, 111 (43%) were benign, and 14 (5%) were unsatisfactory. Of the 136 posi tive FNAs, 28 (21%) revealed metastatic hrmora. The overall incidence of re nal FNAs displaying metastatic tumors was 11 %. Among the 28 patients with metastases to the kidney, 23 patients were men and 5 were women, with the m ean age being 58 yr: Twenty-five patients (89%) had prior history of a prim ary malignancy, including lung carcinoma (11 cases, 39%), lymphoma (8 cases , 29%), hepatocellular carcinoma (3 cases, 11%), and one case each of breas t, pancreatic, and cervical cancer In the remaining 3 patients (11%), with metastatic adenocarcinoma (2 cases) and squamous-cell carcinoma (I case), t he primary tumor site remained unknown despite an extensive clinical workup . Overall survival after FNA was pool; with a mean of 9.8 Ino. FNA is usefu l in the diagnosis of masses in the kidney secondary to metastatic disease. This information is of clinical importance, principally in the exclusion o f a primary malignancy, but also to avoid unnecessary surgery and to plan f or subsequent patient care. (C) 1999 WiIey-Liss, Inc.