Can subcentimetre ultrasound detected angiomyolipomas be safely disregarded?. Issue 4 (April 2020)

• Record Type: Journal Article
• Authors: Hussain, T.; Lam, V.; Farhad, M.; Lee, S.; Stephenson, J.A.; Kockelbergh, R.; Rajesh, A.
• Is Part Of: Clinical radiology. Volume 75:Issue 4(2020)
• Page Start: 287
• Page End: 292
• Publication Date: 2020-04
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2019.12.006
• Languages: English
• ISSNs: 0009-9260

Abstract

Abstract : AIM: To optimise follow-up by dismissing lesions on baseline ultrasound (US) if renal lesions conform to US criteria of an angiomyolipoma (AML). METHOD AND MATERIALS: The present study was a 10-year retrospective review of patients who were found to have incidental hyperechoic renal lesions on US to ascertain the outcome from subsequent imaging, clinical encounters, and cancer registrations. Exclusions included renal calculi, tuberous sclerosis, Von-Hippel–Lindau, or a known cancer. RESULTS: After excluding 39 patients, 1, 493 patients were identified. One hundred and sixty had more than one lesion with 87 patients having bilateral lesions. Regardless of indication, 889 patients had subsequent imaging within 5 years (59.5%). The average size of all AMLs was 13.2 mm. In the group with lesions that were <10 mm (807), 438 had imaging follow-up with an average follow-up time of 1.5 years. Mean lesion size in this group was 7 mm, with an average increase of <0.5 mm on follow-up. No lesions were found to be malignant on subsequent imaging nor did any of these patients have a subsequent renal cancer diagnosis registered at local multidisciplinary team meetings. CONCLUSION: No incidental subcentimetre hyperechoic renal lesion with imaging characteristics of an AML demonstrated significant growth or developed into a malignancy on follow-up. Highlights: 10-year retrospective review to optimise the follow up strategy of angiomyolipomas. No subcentimetre renal lesion with imaging characteristics of an AML grew significantly. No subcentimetre renal lesion with imaging characteristics of an AML was a malignancy on follow up. Subcentimetre asymptomatic AMLs with no concerning features on US can be excluded from further follow up.