Renal leiomyoma

Changed by Giacomo Nicolini, 14 Jul 2016

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Renal leiomyomas are benign tumours of the kidney originating from smooth muscle cells of the renal capsule , pelvis , calices , or blood vessels.

There is a 4% to 5.5% prevalence based on autopsy findings¹.

clinicalClinical presentation

Renal leiomyomas are usually incidental findings.

In symptomatic cases, these lesions can cause abdominal/flank pain and/or palpable mass¹.

pathologyPathology

At macroscopic examination, leiomyomas are typically well-demarcated, solid , firm nodules with rare calcifications and cystic changes, without necrosis.

Microscopically, spindle cells with few nuclear polymorphisms and no mitotic activity are arranged in intersecting fascicles².

diagnosisDiagnosis

Diagnosis in based on histologic analysis.

Ultrasound may display a solid or cystic mass and allow for identification of a plane between the tumour and kidney, but has very poor specificity¹.

Angiographic appearance can be either hypo- or hyper-vascular and features indicative of malignancy, such as vessel encasement, renal vein invasion or arteriovenous shunting, are absent¹.

Computed tomography scanning provides improved anatomic definition and reveals well-circumscribed margins, a capsular/subcapsular or peripelvic origin, minimal parenchymal distortion, and no evidence of extra-renal invasion¹.

Some think density , location and margins of the lesion can help to adress the diagnosis of renal leiomyoma².

-Renal leiomyomas are benign tumours of the kidney originating from smooth muscle cells of the renal capsule , pelvis , calices , or blood vessels.There is a 4% to 5.5% prevalence based on autopsy findings1.<h4>clinical presentation</h4>Renal leiomyomas are usually incidental findings.In symptomatic cases, these lesions can cause abdominal/flank pain and/or palpable mass1.<h4>pathology</h4>At macroscopic examination, leiomyomas are typically well-demarcated, solid , firm nodules with rare calcifications and cystic changes, without necrosis.Microscopically, spindle cells with few nuclear polymorphisms and no mitotic activity are arranged in intersecting fascicles2.<h4>diagnosis</h4>Diagnosis in based on histologic analysis.
+Renal leiomyomas are benign tumours of the kidney originating from smooth muscle cells of the renal capsule , pelvis , calices , or blood vessels.There is a 4% to 5.5% prevalence based on autopsy findings1.<h4>Clinical presentation</h4>Renal leiomyomas are usually incidental findings.In symptomatic cases, these lesions can cause abdominal/flank pain and/or palpable mass1.<h4>Pathology</h4>At macroscopic examination, leiomyomas are typically well-demarcated, solid , firm nodules with rare calcifications and cystic changes, without necrosis.Microscopically, spindle cells with few nuclear polymorphisms and no mitotic activity are arranged in intersecting fascicles2.<h4>Diagnosis</h4>Diagnosis in based on histologic analysis. Ultrasound may display a solid or cystic mass and allow for identification of a plane between the tumour and kidney, but has very poor specificity1.Angiographic appearance can be either hypo- or hyper-vascular and features indicative of malignancy, such as vessel encasement, renal vein invasion or arteriovenous shunting, are absent1.Computed tomography scanning provides improved anatomic definition and reveals well-circumscribed margins, a capsular/subcapsular or peripelvic origin, minimal parenchymal distortion, and no evidence of extra-renal invasion1.Some think density , location and margins of the lesion can help to adress the diagnosis of renal leiomyoma2.

References changed:

1. Andreoiu M, Drachenberg D, Macmahon R. Giant renal leiomyoma: a case report and brief review of the literature. Can Urol Assoc J. 2011;3 (5): E58-60. Free text at pubmed - Pubmed citation
2. L. E. Derchi, N. Grenier, G. Heinz-Peer, V. Dogra, F. Franco, G. A. Rollandi &C. Deminiere (2008) Imaging of Renal Leiomyomas, Acta Radiologica, 49:7, 833-838

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