Renal oncocytoma overview

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Renal oncocytoma from other Diseases

Epidemiology and Demographics

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Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice

History and Symptoms

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Laboratory Findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2] Shanshan Cen, M.D. [3]

Overview

Renal oncocytoma is a relatively rare and benign tumor. On gross pathology, tan or mahogany brown, well circumscribed tumor, and central scar are characteristic findings of renal oncocytoma. On microscopic histopathological analysis, oncocytes and large eosinophilic cells are characteristic findings of renal oncocytoma.[1] Renal oncocytoma must be differentiated from renal cell carcinoma, metanephric neoplasms, and renal leiomyoma. The incidence of renal oncocytoma increases with age; the median age at diagnosis is 55 years. The male to female ratio is approximately 2 to 1.[2] Symptoms of renal oncocytoma include hematuria and flank pain. Abdonimal CT scan, ultrasound, and intravenous pyelogram may be helpful in the diagnosis of renal oncocytoma. Surgery is the mainstay of treatment for renal oncocytoma. Prognosis is generally excellent.[3]

Historical perspective

Renal oncocytoma was first discovered by Zippel, in 1942 and Klein and Valensi were the first to demonstrate the pathologic characteristics of renal oncocytoma as “proximal tubular adenoma with oncocytic features” in 1976.

Classification

There is no established system for the classification of renal oncocytoma.

Pathophysiology

On gross pathology, tan or mahogany brown, well circumscribed tumor, and central scar are characteristic findings of renal oncocytoma. On microscopic histopathological analysis, oncocytes and large eosinophilic cells are characteristic findings of renal oncocytoma.[1]

Causes

There are no established causes for renal oncocytoma.

Differential Diagnosis

Renal oncocytoma must be differentiated from other diseases that cause abdominal mass, abdominal pain and hematuria such as wilms tumor, renal cell carcinoma, rhabdoid kidney disease, polycystic kidney disease, and other urogenital mass.

Epidemiology and Demographics

The incidence of renal oncocytoma is approximately 3% to 7% of solid renal resected tumors. Patients of all age groups may develop renal oncocytoma. The age of patients can be differ from 10 to 94 years. The incidence of renal oncocytoma increases with age; the median age at the time of surgery is 62 to 68 years. Males are more commonly affected by renal oncocytoma than females. The male to female ratio is approximately 2 to 1.

Risk Fctors

There are no established risk factors for renal oncocytoma.

Screening

There is insufficient evidence to recommend routine screening for renal oncocytoma.

Prognosis

Prognosis is generally excellent.[3]

Staging

There is no established system for the staging of reanl oncocytoma.

Diagnosis

History and Symptoms

Symptoms of renal oncocytoma include hematuria and flank pain.

Physical Examination

Physical examination of patients with renal oncocytoma is usually remarkable for a palpable abdominal mass.

Laboratory Findings

There are no diagnostic lab findings associated with renal oncocytoma.

X Ray

X-ray is rarely done for the diagnosis of renal oncocytoma.

CT Scan

Abdonimal CT scan is helpful in the diagnosis of renal oncocytoma.

MRI

MRI may be helpful in the diagnosis of renal oncocytoma.

Ultrasound

Ultrasound may be helpful in the diagnosis of renal oncocytoma.

Other Imaging Findings

Intravenous pyelogram may be helpful in the diagnosis of renal oncocytoma.

Other Diagnostic Studies

There are no other diagnostic study findings associated with renal oncocytoma.

Biopsy

On biopsy, renal oncocytoma is characterized by oncocytes and large eosinophilic cells.

Treatment

Medical Therapy

The mainstay of therapy for renal oncocytoma is surgery.

Surgery

Surgery is the mainstay of treatment for renal oncocytoma.

Primary Prevention

There is no established method for prevention of renal oncocytoma.

Secondary Prevention

There are no secondary preventive measures available for renal oncocytoma.

References

  1. 1.0 1.1 Palmer WE, Chew FS (1991). "Renal oncocytoma". AJR Am J Roentgenol. 156 (6): 1144. doi:10.2214/ajr.156.6.2028856. PMID 2028856.
  2. Renal oncocytoma.Dr Donna D'Souza et al. Radiopaedia.org 2015.http://radiopaedia.org/articles/renal-oncocytoma
  3. 3.0 3.1 Lieber MM (1990). "Renal oncocytoma: prognosis and treatment". European Urology. 18 Suppl 2: 17–21. PMID 2226597.

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