Editing Kidney Cancer: Diagnosis and Evaluation (section)

=== Primary ===

* '''<span style="color:#ff0000">Radiologic classification of renal masses</span>'''
** '''<span style="color:#ff0000">Cystic</span>'''
*** '''<span style="color:#ff0000">Simple vs. Complex</span>'''
**** '''See''' '''[[Benign Kidney Tumours|Benign Renal Tumours]] Chapter Notes'''
** '''<span style="color:#ff0000">Solid</span>'''
***'''<span style="color:#ff0000">Differential diagnosis for radiographically detected solid renal mass:</span>'''
***# '''<span style="color:#ff0000">RCC</span>'''
***# '''<span style="color:#ff0000">Oncocytoma</span>'''
***# '''<span style="color:#ff0000">Angiomyolipoma</span>'''
***# '''<span style="color:#ff0000">Urothelial carcinoma</span>'''
***# '''<span style="color:#ff0000">Metastasis</span>'''
***# '''<span style="color:#ff0000">Abscess</span>'''
***# '''<span style="color:#ff0000">Infarct</span>'''
***# '''<span style="color:#ff0000">Vascular malformation</span>'''
***# '''<span style="color:#ff0000">Renal pseudotumor</span>'''
**** The diagnosis of most of these lesions can be established on the basis of clinical presentation and radiographic features, occasionally combined with endourologic studies or renal mass biopsy. However, '''with the exception of fat-containing AML, it is often not possible to reliably distinguish RCC from benign renal neoplasms,''' including oncocytoma and fat-poor AML, with current diagnostic techniques.
***'''Differential Diagnoses of Infiltrative Masses in the Kidney (7):'''
***# '''Lymphoma'''
***# '''High-grade urothelial carcinoma'''
***# '''Sarcomatoid differentiation (chromophobe is the most prone one to have this)'''
***# '''Collecting duct carcinoma'''
***# '''Renal medullary carcinoma'''
***# '''Xanthogranulomatous pyelonephritis (XGP)'''
***# '''Metastasis (occasionally)'''
*'''Goals of imaging are to evaluate (4):'''
*# '''Renal mass characteristics'''
*#* Tumor size
*#**Size is inversely correlated with risk of malignancy
*#***Proportion of surgically resected masses found to be benign[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2734327/]
*#****<2cm: 25%
*#****<4cm: 19%
*#*Tumor complexity
*#* Degree of contrast enhancement
*#* Presence or absence of fat
*#* Involvement of or juxtaposition to the renal hilum, vein, or collecting system
*# '''Contralateral kidney'''
*# '''Regional lymphadenopathy'''
*# '''Adrenal involvement'''
*##'''Findings suggestive of ipsilateral adrenal involvement (3):'''
*### '''Enlarged or indistinct adrenal gland on imaging'''
*### '''Extensive malignant replacement of the kidney'''
*### '''Palpably abnormal adrenal gland'''