Çocukluk Yaş Grubunda Benign Renal Kitlesel Lezyonlar
Synopsis
In childhood, renal masses are mostly detected incidentally during routine examinations or evaluations for other conditions. Since malignant renal masses are rare, accounting for only 7% of all pediatric cancers, accurately differentiating benign from malignant lesions is of paramount importance. This differentiation requires a multidisciplinary approach involving pediatric nephrology, pediatric oncology, radiology, surgery, and pathology. During the diagnostic process, cross-sectional imaging modalities such as ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) are utilized alongside clinical history, physical examination, and laboratory findings. While US enables the differentiation between cystic and solid structures, MRI stands out due to its high soft-tissue contrast and lack of radiation exposure. Benign renal lesions identified in children include simple cysts, which are the most common and classified under Bosniak Categories 1 and 2; angiomyolipomas, which are associated with tuberous sclerosis in 80% of cases and can be treated with mTOR inhibitors; metanephric adenoma, a rare epithelial/stromal tumor; oncocytoma, which contains a central scar; reninoma, characterized by hypertension, hypokalemia, and high renin activity; ossifying renal tumor of infancy, causing painless gross hematuria; multicystic cystic nephroma, which may require surgical resection; and renal pseudotumors secondary to focal pyelonephritis or congenital anomalies.
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