Sarcomatoid Renal Cell Carcinoma and Collecting Duct Carcinoma: Discrimination From Common Renal Cell Carcinoma Subtypes and Benign RCC Mimics on Multiphasic MDCT

Academic Radiology
Jonathan R YoungSteven S Raman

Abstract

To investigate whether imaging features on multiphasic multidetector computed tomography (MDCT) can help discriminate sarcomatoid renal cell carcinoma (RCC) and collecting duct carcinoma (CDC) from other solid renal masses. With institutional review board approval for this HIPAA-compliant study, we derived a cohort of 7 sarcomatoid RCCs, 4 CDCs, 165 clear cell RCCs, 56 papillary RCCs, 22 chromophobe RCCs, 49 oncocytomas, and 16 lipid-poor angiomyolipomas with preoperative multiphasic MDCT with up to four phases (unenhanced, corticomedullary, nephrographic, and excretory). Each lesion was reviewed for contour, spread pattern, pattern of enhancement, neovascularity, and calcification. Sarcomatoid RCCs and CDCs were more likely than other solid renal masses to have an irregular contour (64% vs 2%, P < 0.001) and an infiltrative spread pattern, defined as infiltration into adjacent renal parenchyma, collecting system, or neighboring structures (82% vs 7%, P < 0.001). When used to discriminate sarcomatoid RCC and CDC from other solid renal masses, an infiltrative spread pattern had a specificity of 93% (287/308) and sensitivity of 82% (9/11), and an irregular contour had a specificity of 98% (303/308) and sensitivity of 64% (7/11). ...Continue Reading

Citations

Jun 3, 2018·World Journal of Urology·Cedric LebacleAlexandra Drakaki
Jan 16, 2021·Radiographics : a Review Publication of the Radiological Society of North America, Inc·David E SweetErick M Remer
Aug 24, 2019·European Urology Oncology·Hajime TanakaSteven C Campbell
Aug 21, 2021·International Journal of Urology : Official Journal of the Japanese Urological Association·Wataru ShimadaYasuhisa Fujii
Jan 7, 2021·Archives of Pathology & Laboratory Medicine·Nicholas BaniakMichelle S Hirsch

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