ORIGINAL ARTICLES   

Minerva Urologica e Nefrologica 2011 December;63(4):281-6

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: English

Isolated nodular metastases in perirenal space: our experience of nine cases and review of the literature

La Fianza A. ¹, Maccabelli G. ¹, Van Der Byl G. ¹, Prevedoni Gorone MS. ², Gregoli B. ¹ ✉

¹ Department of Radiology, University of Pavia, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy; ² Department of Radiology, Hospital of Cremona, Cremona, Italy

AIM: The aim of this paper was to report authors’ experience and review of the literature on rare isolated perirenal space metastases from different primary tumors.
METHODS: From January 2004 to August 2008 we evaluated retrospectively 9 patients with isolated nodular neoplastic lesions of the perirenal space with computed tomography (CT) imaging and we reported the follow-up after relapse of disease.
RESULTS:All the masses resulted being of secondary tumor involvement (melanoma (2/9 cases 22.22%), esophagus-gastric tract adenocarcinoma (3/9 cases 33.33%), gynecological tumor (2/9 cases 22.22%) and gastrointestinal tumor (2/9 cases, 22.22%), diagnosed by biopsy CT-guided (2 cases), or histological post-surgical examination (1 case), or clinical and instrumental follow-up (4 cases) or postmortem examination (2 cases). The lesions were bilateral in 3 cases and monolateral in 6 cases, isolated in four cases and multiple in five cases; they have demonstrated partially necrotic parenchymal density as soft tissues masses, with frequently hypervascularization, with portal venous enhancement. The dimensions of lesions resulted to be between minimal value of about 7-8 mm and maximum value of about 50 mm (mean 29 mm). The patients had generally poor prognosis (death for disease ‑ DOD ‑ in 5 cases; life with disease – LWD ‑ in four cases).
CONCLUSION: Isolated perirenal metastases are unusual site of relapse of disease. Our study confirms the utility of CT evaluation of metastatic localization of perirenal space; this technique can also be used for focused biopsies and follow-up. This site of isolated metastases had a poor prognosis.