authors
-
Wiesław Urbanowicz 1, Michał Wolnicki 1, Jerzy Starzyk 2
- 1 Klinika Urologii Dziecięcej Katedry Chirurgii Pediatrycznej, Instytut Pediatrii Wydziału Lekarskiego Uniwersytetu
Jagiellońskiego w Krakowie
Kierownik: dr hab. med. Wiesław Urbanowicz
2 Klinika Endokrynologii Dzieci i Młodzieży Katedry Pediatrii Uniwersytetu Jagiellońskiego w Krakowie
Kierownik: prof, dr hab. med. Antoni Dziatkowiak
keywords
-
children, kidney\'s cysts, Bosniak\'s classification
summary
- Introduction. In children cystic lesions of the kidney vary as to their morphology and oncological classification. Simple renal cysts are rare in pediatric population, but in view of their non-uniform clinical picture, a possibility of mistaking for malignant lesions and associated symptoms, such cysts pose a serious diagnostic and therapeutic problem. The classification of Bośniak was to be helpful in resolving these issues.
- Material and method. The analysis included seven patients treated for simple renal cysts between 1986-98. The most common presenting symptoms were abdominal pain, erythrocyturia, recurrent urinary tract infections and hypertension. In six children the lesions were classified as Bośniak type I and one as Bośniak type III. In six patients the cysts were surgically removed, while the seventh, whose the lesion was below 2.5 cm in size, was followed-up.
- Results. All the patients did well postoperatively and no complications were noted. The cyst associated symptoms resolved. Hi-stopathology confirmed simple renal cysts in all the children.
- Conclusions. In absence of conclusive imaging, cytological and immunological diagnostic methods when dealing with a patient with a renal cyst the surgeon is often inclined to undertake surgical intervention. Videoscopic procedures seem to combine the advantages of open surgery without the disadvantages of the classic procedures.
references
- 1. De Weerd JM, Simon HB: Simple Renal Cystis in Children: review ofihe literature and report of 5 cases. J Urol 1956, 75: 912-921.
- 2. Bartholomew TH, Slovis TL, Kroovand RL, et al.: The sonographic evaluation and manegement of simple renal cystis in children. J Urol 1980: 123: 732.
- 3. Bośniak MA: The current radiologic approach to renal cyst. Radiology 1986, 1958: 1.
- 4. Bośniak MA: The use of the Bośniak Classification System for Renal Cystis and Cystic Tumors. 1997, 1957, 1852-1853.
- 5. Cloix P, Martin X, Pangaud C, Marechal J. M, Bouvier R, Ba-rat D, Dubernard JM: Swgical Management of Complex Renal Cysiis: A Series of 32 Cases. J Urol 1996,156, 28-30.
- 6. Babka JC, Cohen MS, Sode J: Solitary Intrarenal Cyst Causing Hypertension. N Engl J Med 1974, 291: 343.
- 7. Bowers DL, Ikeguchi EF, Sawczuk IS: Transition from renal cyst to a renal carcinoma detected by ultrasonography. Brit J Urol 1997,80,495-496.
- 8. Glassberg Kl, Stephens FD, Lebowitz RL: Renal dysgenesis and cystic disease of the kidney: a report Comittee on Terminology, Nomenclature and Classification. Section on Urology. American Academy of Pediatrics, J Urol 1987, 138: 1085.
- 9. Gordon LR, Pollack HM, Popky LG, Duckett Jr, JW: Simple Serous Cysts of the Kidney in Children. Radiology 1979, 131, 357-361.
- 10. Gauzzoni G, Montorsi F, Bergamashi F: Laparoscopic unroofing of simple renal cysts. J. Urol. 1994, 43: 154-159.
- 11. Hanna RM, Dahniya MH: Aspiration and sclerotherapy of symptomatic simple renal cysts: value of two injections of a sclerosing agent. Am J Roentgenol 1996, 167: 781-783.
- 12. Hariman DS, Weatherby E, Laskin WB: Cystic renal cell carcinoma: CT findings simulating a benign hyperdense cyst. AJR 1992, 159, 1235.
- 13. Koga S, Nishikido M, Inuzuka S, Sakamoto I, Hayashi T, Hay-ashi K, Saito Y, Kanetake H.An evaluation of Bosniak\\\'s radiological classification of cystic renal masses. BJU Intern. 2000,86, 607-609.
- 14. Marshall FF, et al.: Textbook of Operative Urology. W. B. Saunders Company, 1996, 48-60.
- 15. Horchani A, Nouira Y, Kbaier I, Altyaoui F, Zribi AS: Hydatid Cyst of the Kidney. Eur. Urol. 2000, 38: 461-467.
- 16. Miller MA, Brown J.I: Renal cysts and cystic neoplasms. Magn Rcson Im Clin N Am 1997, 5, 49-66.
- 17. Morgan C, Radar D: Laparoscopic unroofing of a renal cyst. J Urol 1992, 148: 1835.
- 18. Rogowski K, Darcwicz B, Malczyk E, Darewicz J, Kudelski J: Wartość badania cytologicznego płynu w torbielach nerek w aspekcie wczesnego wykrywania zmian neoplazmatycznych. Uroi Pol 1997, 50, 2A, 145.\\\"
correspondence
Wiesław Urbanowicz
Klinika Urologii Dziecięcej Katedry Cliintrgii Pediatrycznej
ul. Wielicka 265
30-663 Kraków
|