Qingwen L, Sheng X, Sheng W, Jianmin L, Jiajun Z, Zhijun C, Chengyong W, Jian L and Shuai Y
Object
Improve the diagnosis and treatment of calcified renal masses.
Method
We respectively reviewed 3 cases of abnormally calcified renal masses admitted to our hospital. We evaluated the clinical manifestations in the patients we treated and reviewed the literature regarding the diagnosis and treatment of calcified renal masses. Case 1, a 21 year old male, was evaluated for a right renal space-occupying lesion found incidentally on physical examination. CT imaging revealed a space-occupying lesion in the middle lower pole of the right kidney with peripheral circular calcifications and irregular calcifications. The lesion was low density on CT. Case 2, a 44 year old male, presented with right flank swelling pain and discomfort for 10 days. KUB and CT imaging demonstrated an abnormal round calcification in the dorsal midpole of the left kidney. Case 3, a 53 year old female, presented with dull left flank pain for more than 2 years. KUB and CT showed a round calcified lesion in the upper pole of the left kidney.
Results
The diagnosis of renal cancer was made before surgery in patient 1 and radical nephrectomy was carried out. The pathological diagnosis was papillary renal cell carcinoma. The patient was followed for 27 months and was free of recurrence and metastases. The preoperative diagnosis of patient 2 was benign renal tumor. The patient underwent enucleation of the renal tumor. Pathologic examination revealed clear cell renal carcinoma. A radical nephrectomy was then performed. The patient was followed for 37 months and was free of recurrence and metastases. The preoperative diagnosis in patient 3 was left renal calyceal stones. The patient underwent wedge resection of left renal parenchyma. Pathologic examination revealed an abnormal left renal calcification with inflammatory cell infiltration. The patient was followed for 39 months and remained in good health.
Conclusion
Calcified renal masses are rare manifestations of renal cancer. It is difficult to make the diagnosis before surgery, but the prognosis is favorable. Nephron sparing surgery (NSS) is the choice of treatment.
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