신세포암에 있어서 신장 윤곽 융기에 관한 방사선학적 고찰 = A Radioligic Study of Renal Contour Bulging in Renal Cell Carcinomas

다국어 초록 (Multilingual Abstract)

We analyzed radiologic findings of 34 renal cell carcinomas (RCCs) of excretory urography, angiography, sonogram, CT, or MRI, with emphasis on renal contour bulging. Renal contour bulging was noted in all cases including two small hyperechoic RCCs (stage I) of less than 3cm in diameter on ultrasonography. The border of contour bulging tended to be smooth (9/10 = 90%) and symmetric (8/10 = 80%) in stage I RCCs, but irregular (13/16 = 81%) and asymmetric (9/16 = 56%) in stage IV RCCs. The diameter ratio of the bulging portion of the tumor to the tumor as a whole did not show any statistically significant difference to the stage of RCCs. Radiologic findings of pelvicaliceal involvement of RCCs (hydrocalyx, hydronephrosis, non-opacification of the affected kidney, etc.) were demonstrated in seven cases (21%), and all these seven RCCs were longer than 5cm in diameter and six of seven RCCs belnged to stage IV. All five cases less than 5cm in diameter were of stage I, whereas all three RCCs greater than 15cm were of stage IV. Only two patients (6%) of stage IlIc & IV showed impairment of renal function on the basis of increased serum creatinine level and clinical findings.
Renal contour bulging adjacent to a renal solid or complex tumor without dilatation of pelvicaliceal system or impairment of renal function can be used as one of useful criteria to diagnose and stage RCCs and differentiate them from uroepithelial tumors in adult kidneys.