A study of the causes of misdiagnosis between renal cell carcinoma and renal angiomyolipoma / 中华泌尿外科杂志

ABSTRACT

Objective To study the causes of misdiagnosis between renal cell carcinoma (RCC) and renal angiomyolipoma (RAML). Methods Since 1990, 228 cases of RCC and 62 RAML were surgically treated.13 of them,4 RCC and 9 RAML were incorrectly treated because the misdiagnosis on imaging examination or intraoperative frozen section study. The causes were analyzed. Results 4 RCC underwent enucleation or simple nephrectomy because of the frozen section diagnosis of RAML.None have developed recurrent RCC with 1～4 years of follow up.Of the 9 RAML cases,6 have been misdiagnosed as RCC on imaging procedures.The other 3 patients that failed to reach a proper diagnosis on imaging examination were submitted to intraoperative frozen section studies.1 was diagnosed as RCC and the other 2 remained uncertain. Radical nephrectomy have been performed for 9 patients. Conclusions Difficult interpretation due to poor quality of frozen sections is a potential cause of diagnosis error.RCC might be confused with RAML when the specimens contained highly vascular tissue. The content and distribution of fat is the main cause of imaging misdiagnosis.