Ces Urol 2016, 20(3):204-213 | DOI: 10.48095/cccu2016032

Cystic tumors of the kidney

Tomáš Pitra¹, Kristýna Pivovarčíková², Ivan Trávníček¹, Kristýna Procházková¹, Ondřej Hes², Hynek Mírka³, Radek Tupý³, Milan Hora¹

¹ Urologická klinika LF UK a FN Plzeň

² Šiklův ústav patologie LF UK a FN Plzeň

³ Klinika zobrazovacích metod LF UK a FN Plzeň

Pitra T, Pivovarčíková K, Trávníček I, Procházková K, Hes O, Mírka H, Tupý R, Hora M. Cystic tumors of the kidney. Major statement: Review dealing with clinical manifestation, diagnostic process and management of cystic tumors of the kidney. Review of literature.

Introduction: A relatively small part of tumors of kidney is manifested as cystic tumors - 8% - based on our cohort of patients. Both benign and malignant lesions are included in this group. Such lesions have generally better prognosis than so-called solid tumors. Overview of cystic renal lesions: Typical representatives of tumors included in the cystic group are - multilocular cystic renal neoplasm of low malignant potential, mixed epithelial and stromal tumor of kidney (MESTK), and tubulocystic renal cell carcinoma. Secondary cystic changes can be seen mostly in clear cell renal cell carcinoma and papillary renal cell carcinoma type 1. Imaging: The classification and following management of these lesions is based on Bosniak classification of cystic renal masses. Magnetic resonance imaging (MRI) and contrast enhanced ultrasound (CEUS) are other modalities, which can be used to refine the diagnosis/differential diagnosis. Results of both these methods can be classified using Bosniak classification system. Management: Management of cystic lesion depends on classification. Bosniak I and II type cysts are lesions, that are considered to be benign and no follow-up is needed. Bosniak III and IV type cysts are the surgical lesions. In the Bosniak III category the risk of aggressive tumor is minimal, so nephron sparing surgery is recommended. Bosniak IIF is frequently discussed. There are no straightforward guidelines with regard to the appropriate management of this group. Follow-up is the most frequent recommendation.

Keywords: Bosniakova klasifikace, cystické nádory ledvin, diagnostika, management.

Received: June 7, 2016; Accepted: August 5, 2016; Prepublished online: August 29, 2016; Published: September 30, 2016