Beruflich Dokumente
Kultur Dokumente
oleh
Nurin Pascarini Jusaim
1102012205
Pembimbing
Kombes Pol. dr. A. Munir, Sp. Rad
Introduction
01
Background and Aim
02
TABLE OF 03 Materials
CONTENTS 04 Methods
Results
05
Conclusion
06
2
I N T R O D U C T I O N
Primary renal malignancies in patients
younger than 20 years of age
2% 1%
5%
Wilms Tumor
Rhabdoid tumor
92%
5
01
Exclusion criterias
6
02
03
CT / MRI Examination
Reviewed in consensus by
two radiologists
CT Exam
Only axial images were reviewed
7
04
Tumor Staging
8
American Joint Committee on Cancer (AJCC) 2010 TNM staging system for renal cell carcinoma
06
Confirming the histopathological findings
The original hematoxylin and eosin stained slides
from each case were reviewed by a single pathologist
10
results
History of Renal Cell Carcinoma
8 children 1 boy 1 girl (16 year-old)
had metachronous with tuberous sclerosis was
had a solitary renal tumor
bilateral renal tumors excluded from imaging review due
to the presence of bilateral
multicentric RCC (Fig. 1)
12
Only contrast-enhanced CT
8 tumors
Staging
both CT and MRI
1 tumors
13
Mean pediatric RCC maximum diameter was
6.2 cm (range 1.512.6 cm)
14
Left stage 3 renal cell carcinoma in an 11-year-old girl
Five (50%) tumors had internal or adjacent hemorrhage
15
Left stage 3 renal cell carcinoma
Right stage 4 renal cell carcinoma Right stage 3 renal cell carcinoma in a 7-year-old girl with
in a 17-year-old girl in a 9-year-old boy a history of right Wilms tumor
A single child had evidence of distant There is an enlarged pathological A bulky, heterogeneous left para-aortic
abdominal metastatic disease lymph node located posterior to the lymph node (arrowheads)
IVC (arrow)
A small predominantly hyperintense,
hemorrhagic mass (arrow)
16
Radiologic vs surgicopathologic TNM staging of pediatric renal cell carcinoma
17
Discussion
01 02 03
While pediatric RCC is commonly Pediatric RCC has a widely variable Imaging overestimated the
initially recognized by sonog- raphy, radiologic appearance. While tumors are appropriate T stage. The results
subsequent imaging with either most commonly solitary, multifocal, suggest inaccurate T staging most
bilateral and metachronous disease may
contrast-enhanced CT or MRI is often often occurs when an incorrect
be detected. The tumors in our study
deemed necessary to define exact determination is made regarding
were quite variable in size, ranging from
local extent of the neoplasm, identify whether a tumor has breached the
1.5 to 12.6 cm, and most demonstrated a
the presence of lymph node heterogeneous postcontrast
renal capsule to involve perinephric
metastasis and detect distant enhancement pattern. Intrale- sional or fat
metastatic disease perilesional hemorrhage was quite
common
18
RCC is an uncommon primary renal malignancy in
conclusion
children and adolescents
19
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