The incidence of malignant transformation of renal cysts of category 1, 2, and 2F by the BOSNIAK classification into multilocular cystic renal cell carcinoma


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Abstract

Relevance. Renal cysts remain the most common of benign renal lesions, but current literature is lacking large observational studies on the incidence of their malignant transformation. Aim. To assess the incidence of malignant transformation of renal cysts of category 1, 2, and 2F by the Bosniak classification into multilocular cystic renal cell carcinoma. Materials and methods. From January 2009 to December 2017, 177 patients with renal cysts of category 1 (n=50), 2 (n=74), and 2F (n=53) underwent laparoscopic decortication. In 10 cases, post-operative histological and immunohistochemical studies revealed foci of grade 1 (pT1a) multilocular cystic renal cell carcinoma. Results. Foci of grade 1 (pT1a) multilocular cystic renal cell carcinoma were detected in 10 (5.65%) patients (five men, five women, mean age 58.9 years). The incidence of malignant transformation of renal cysts of categories 1, 2, and 2F was 0%, 2.7% (2 of 74 patients), and 15.1% (8 of 53 patients), respectively. Subsequently, all ten patients were submitted to surgical treatment: eight of them underwent a partial nephrectomy, and two received a nephrectomy. During a median of 49.3 (31-72) months follow-up, no metastasis, and recurrence of multilocular cystic RCC were observed. Conclusion. A more modern algorithm for managing patients with Bosniak category 1, 2 and 2F cysts need to be developed to establish early surveillance of patients starting with category 1 cysts. Given the low malignant potential of these tumors, they should be treated with organsparing surgery.

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About the authors

S. P Darenkov

Central State Medical Academy at the Administrative Directorate of the President of the RF; Clinical Hospital at the Administrative Directorate of the President of the RF

Email: darenkov@list.ru
Dr.Med.Sci., Prof., Head of the Center of Urology, Clinical Hospital of the ADP RF, Head of the Department of Urology, CSMA at the Administrative Directorate of the President of the RF

A. A Proskokov

Central State Medical Academy at the Administrative Directorate of the President of the RF; Clinical Hospital at the Administrative Directorate of the President of the RF

Email: dr.proskokov@mail.ru
Ph.D., Head of the Department of Urology №1

A. A Agabekian

Central State Medical Academy at the Administrative Directorate of the President of the RF; Clinical Hospital at the Administrative Directorate of the President of the RF

Email: dr.agabekian@mail.ru
Resident at the Department of Urology, CSMA at the Administrative Directorate of the President of the RF

I. A Trofimov

Central State Medical Academy at the Administrative Directorate of the President of the RF; Clinical Hospital at the Administrative Directorate of the President of the RF

Email: ia.trofim@gmail.com
Urologist at the Department of Urology №1

References

  1. Bas O., Nalbant I., Sener C., Firat H., Yeçil S., Zengin K., Yalcinkaya F., Imamoglu A. Management of Renal Cysts. JSLS. 2015;19(1): e2014.00097. doi: 10.4293/JSLS.2014.00097.
  2. Skolarikos A., Laguna M.P., de la Rosette J.J. Conservative and radiological management of simple renal cysts: a comprehensive review. BJU Int. 2012;110(2):170-8. Doi: 10.1111/j. 1464-410X.2011.
  3. Hemal A.K. Laparoscopic management of renal cystic disease. Urol Clin North Am. 2001;28:115-126.
  4. Bosniak M.A. The current radiological approach to renal cysts. Radiology. 1986;158:1-10. doi: 10.1148/radiology.158.1.3510019.
  5. Bosniak M.A. Problems in the radiologic diagnosis of renal parenchymal tumors. Urol Clin North Am. 1993;20:217-230.
  6. Bosniak M.A. Diagnosis and management of patients with complicated cystic lesions of the kidney. AJR Am J. Roentgenol. 1997;169:819-21. doi: 10.2214/ajr.169.3.9275903.
  7. Bosniak M.A. The use of the Bosniak classification system for renal cysts and cystic tumors. J. Urol. 1997;157:1852-53. Doi: 10.1016/ S0022-5347(01)64883-3.
  8. Muglia V.F., Carlos A. Bosniak classification for complex renal cysts: history and critical analysis. Westphalen Radiologia Brasileira. 2014;47(6):368-373.
  9. Eknoyan G. A clinical view of simple and complex renal cysts. J. Am Soc Nephrol. 2009;20:1874-1876.
  10. Smith A.D., Remer E.M., Cox K.L., Lieber M.L., Allen B.C., Shah S.N., Herts B.R. Bosniak category IIF and III cystic renal lesions: outcomes and associations. Radiology. 2012;262:152-160. doi: 10.1148/radiol.11110888.
  11. O’Malley R.L., Godoy G., Hecht E.M., Stifelman M.D., Taneja S.S. Bosniak category IIF designation and surgery for complex renal cysts. J. Urol. 2009;182:1091-1095. doi: 10.1016/j.juro.2009.05.046.
  12. Song C., Min G.E., Song K., Kim J.K., Hong B., Kim C.S., Ahn H. Differential diagnosis of complex cystic renal mass using multiphase computerized tomography. J. Urol. 2009;181:2446-50. doi: 10.1016/j.juro.2009.01.111.
  13. Малхасян В.А., Семенякин И.В., Андреев Р.Ю., Иванов В.Ю., Махмудов Т.Б., Пушкарь Д.Ю. Лапароскопическое иссечение кисты почки (Deroofing). Вопросы урологии и андрологии. 2017;5(2):45-50
  14. Hinev A., Anakievski D. Acta Chir Iugosl. Laparoscopic transperitoneal renal cyst decortication. 2014;61(1):35-40.
  15. Gadelmoula M., KurKar A., Shalaby M.M. The laparoscopic management of symptomatic renal cysts: A single-centre experience. Arab J. Urol. 2014;12(2):173-177. doi: 10.1016/j.aju.2013.12.001.
  16. Алексеев Б.Я., Шевчук И.М., Ефремов Г.Д., Самойлова С.И. Мультилокулярная кистозная почечная неоплазия низкого злокачественного потенциала: опыт НИИ урологии и интервенционной радиологии им. Н.А. Лопаткина. О.У. 2017;3:34-38. doi: 10.17650/1726-9776-2017-13-3-34-38
  17. Srigley J.R., Delahunt B., Eble J.N., Egevad L., Epstein J.I., Grignon D., Hes O., Moch H., Montironi R., Tickoo S.K., Zhou M., Argani P. The International Society of Urological Pathology (ISUP) Vancouver classification of renal neoplasia. Am J. Surg Pathol. 2013;37(10):1469-1489. doi: 10.1097/PAS.0b013e318299f2d1.
  18. Mousessian P.N., Yamauchi F.I., Mussi T.C., Baroni R.H. Malignancy Rate, Histologic Grade, and Progression of Bosniak Category III and IV Complex Renal Cystic Lesions. AJR Am J Roentgenol. 2017;209(6):1285-1290. doi: 10.2214/AJR.17.18142.
  19. Schoots I.G., Zaccai K., Hunink M.G., Verhagen P.C.M.S. Classification for complex renal cysts reevaluated: a systematic review J Urol. 2017;198(1):12-21. doi: 10.1016/j.juro.2016.09.160.
  20. Whelan T.F. Guidelines on the management of renal cyst disease. Can Urol Assoc J. 2010;4:98-99.
  21. Jhaveri K., Gupta P., Elmi A., Flor L., Moshonov H., Evans A., Jewett M. Cystic renal carcinomas: do they grow, metastasize, or recur? AJR Am J Roentgenol. 2013;201(2):292-296. Doi: 10.2214/ AJR.12.9414.

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