Renal Tumor or Kidney Tumor: Differential Diagnosis
Differential Diagnosis of Renal Tumors
Inflammatory renal tumors:
- Renal abscess or perinephric abscess
- Xanthogranulomatous pyelonephritis
- Infected renal cyst
- Tuberculosis
- Rheumatic granuloma
Tumors of Renal Parenchyma:
- Renal cell carcinoma
- Renal adenoma
- Wilms' tumor
Tumors of the renal pelvis:
- Papilloma of the urothelium
- Transitional cell carcinoma
- Squamous cell carcinoma
- Adenocarcinoma
Cystic renal tumors:
- Simple or complicated renal cyst
- Parapelvic renal cyst
- Benign multilocular cyst
- Caliceal diverticula
- Cystic nephroma
- Autosomal dominant polycystic kidney disease (ADPKD)
- Autosomal recessive polycystic kidney disease (ARPKD)
- von Hippel-Lindau syndrome
- Tuberous sclerosis
- Cysts from the lymphatic system
Renal tumors of the vascular system:
- Hemangioma
- Hamartoma
- Lymphangioma
- Angiomyolipoma
Renal tumors of the nervous system:
- Neuroblastoma
- Schwannoma
Mesenchymal renal tumors:
- Benign tumors: fibroma, lipoma, leiomyoma
- Malignant tumors: fibrosarcoma, liposarcoma, leiomyosarcoma,
Perirenal renal tumors:
- Extragonadal germ cell tumors
- Lymph node metastases (e.g. testicular cancer)
- Lymphoma
- Retroperitoneal sarcoma
Renal metastases:
Renal metastases are the most common malignant manifestation of the kidneys in autopsies. Common primary cancer sites are lung cancer, breast cancer, gastrointestinal cancer, malignant melanoma and lymphoma.
Diagnostic Work-Up for Renal Tumors
Laboratory tests:
- Urine sediment
- Creatinine
- Blood count
- CRP
Ultrasonography:
Renal sonography is the basic imaging tool for renal tumors. Suspicious lesions of the kidney in ultrasound imaging are further investigated with computed tomography or MRI.
Abdominal CT:
Abdominal CT is the imaging test of choice to verify a renal tumor. In addition to diagnosis and preoperative staging, the renal function of both kidneys can be estimated.
MRI:
Abdominal MRI is indicated in renal insufficiency, contraindication to contrast media, in doubtful findings in CT or if vena cava thrombus is present.
Surgical exploration:
Surgical exploration of the kidney is indicated for renal tumors, if malignant disease has to be ruled out with a histological diagnosis.
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References
- A. J. Wein, L. R. Kavoussi, A. C. Novick, A. P. Partin, und C. A. Peters.
- Campbell-Walsh Urology.
Saunders, Philadelphia, 9th edition, 2007.
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Deutsche Version: Differentialdiagnose Nierentumor
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Dr. med. Dirk Manski
man...@urologielehrbuch.de