Department of Radiology.
Department of Critical Care Medicine.
Medicine (Baltimore). 2021 Feb 12;100(6):e24629. doi: 10.1097/MD.0000000000024629.
Hemangioblastomas in the kidney are rare. Although a few cases of renal hemangioblastoma (RH) have been reported, the content of these articles mainly focused on clinical and pathological research, with minimal descriptions of radiologic findings. Moreover, there are no descriptions of magnetic resonance imaging (MRI) with enhancement of this condition. Herein, we report 2 cases of RH with computed tomography (CT) and MRI findings.
Two patients presented to our institution because of dull pain in the left abdomen, and a mass in the left kidney was found by ultrasound examination in each case. The patient had no special family history. Physical examination revealed no obvious tenderness or percussion pain in the renal and ureteral walking areas, and there was no obvious mass. Routine blood and urine tests were normal, and the serum tumor markers were negative. No obvious lesions were found on imaging of the other body parts.
Similar radiologic findings were observed in both cases and mimicked those of cavernous hemangiomas of the liver, including peripheral nodular enhancement in the corticomedullary phase, progressive centripetal enhancement in the nephrographic and delayed phases, and occasional complete "filling in" in the delayed phase. We made a radiologic diagnosis of renal clear cell carcinoma for patient 1 and suspected renal clear cell carcinoma for patient 2, but the pathological results showed RH.
Given the suspicion of renal cell carcinoma, both patients underwent partial nephrectomy.
The recovery of the two patients was uneventful, and there was no evidence of local recurrence or metastasis many years after surgery.
RH is a rare benign tumor that can be easily misdiagnosed as clear cell carcinoma. Characteristic CT and MRI manifestations may improve preoperative diagnostic accuracy to avoid surgery or indicate nephron-sparing surgery.
肾脏中的血管母细胞瘤较为罕见。虽然已有少数肾血管母细胞瘤(RH)的病例报告,但这些文章的内容主要集中在临床和病理研究方面,对影像学表现的描述较少。此外,对于该病症的增强磁共振成像(MRI)也鲜有描述。在此,我们报告 2 例 RH 的 CT 和 MRI 表现。
2 位患者因左腹部隐痛就诊于我院,且在每例患者中均通过超声检查发现左肾占位。患者无特殊家族史。体格检查未见肾输尿管走行区明显压痛或叩击痛,亦无明显肿块。血常规和尿常规检查均正常,血清肿瘤标志物均为阴性。其他部位影像学检查未见明显异常。
2 例患者的影像学表现相似,类似于肝海绵状血管瘤,包括皮质-髓质期周边结节样强化、肾实质期和延迟期向心性进行性强化,以及偶尔在延迟期完全“填充”。我们对 1 例患者做出了肾透明细胞癌的影像学诊断,对另 1 例患者则怀疑为肾透明细胞癌,但病理结果显示为 RH。
鉴于对肾细胞癌的怀疑,2 位患者均接受了部分肾切除术。
2 位患者均恢复顺利,术后多年无局部复发或转移的证据。
RH 是一种罕见的良性肿瘤,容易误诊为透明细胞癌。特征性 CT 和 MRI 表现可能提高术前诊断准确性,避免过度治疗或提示行保肾手术。