Endovascular management of vascular renal injuries: outcomes and comparison between traumatic and iatrogenic settings.

PURPOSE: To evaluate the efficacy of endovascular treatment for vascular renal injuries (VRIs) like bleeding, pseudoaneurysm and artero-venous fistula (AVF) and to compare patients with blunt trauma (T-VRIs) with those with iatrogenic damage (I-VRIs). METHODS: We retrospectively assessed 49 renal artery embolizations performed to treat T-VRIs (26.5%) and I-VRIs (73.5%). Different embolic materials were used based on the type of lesion. Technical success was defined as the complete occlusion of target arteries with no further visualization of VRIs. Clinical success was defined if no recurrence was present and if renal function (difference between creatinine after and before treatment <0.5 mg/dl) was preserved after 1 month. RESULTS: Angiography showed bleeding in 27 patients, pseudoaneurysm in 29 and an AVF in 6. Embolic agents used were coils in 39 procedures, coils with sponge in four and others in six. Technical success was 100% while clinical success was 85.7% due to seven patients with recurrence. The group I-VRIs showed a higher rate of clinical success than the group T-VRIs (94.4% vs 61.5%; p < 0.05). Moreover, the group I-VRIs had a higher incidence of pseudoaneurysms and AVFs compared with the group T-VRIs (69.4% vs 30.8% and 16.7% vs 0%; p < 0.05). CONCLUSION: Endovascular treatment for VRIs showed satisfactory results and no patient had a worsening of renal function. I-VRIs had better clinical success and more frequently appeared as pseudoaneurysms compared to T-VRIs: probably iatrogenic injury is localized and pseudoaneurysm is easily identifiable and treatable with endovascular treatment.

Invasive ductal carcinoma mammographic findings: Correlation with age, breast composition and tumor size.

BACKGROUND/OBJECTIVE: The aim of this study was to identify the mammographic findings associated with malignancy in different age groups, taking into account breast composition (BC) and lesion size. METHODS: Preoperative mammograms of 1023 invasive ductal carcinomas were retrospectively evaluated. According to the American College of Radiology Breast Imaging Reporting and Data System, cancer mammographic findings were classified as mass, calcifications, architectural distortion and asymmetry, and breasts were assessed as non-dense (A or B BC) and dense (C or D BC). Patient cohort was subdivided into three age groups (group 1: <50 years of age; group 2: between 50 and 69; group 3: ≥70 years of age). RESULTS: Significant results of multinomial logistic regression were the association between mass and non-dense breast (p < 0.0001) and the association between mass and tumor size larger than 15 mm (p = 0.0049). CONCLUSIONS: Mass finding of invasive ductal breast carcinoma is associated with breast composition and tumor size.

A simple cyst is not always simply a cyst: A case of cystic recurrence after nephrectomy for tubulocystic renal cell carcinoma and literature review.

Tubulocystic renal cell carcinoma is a rare subtype of renal tumor according to the 2016 World Health Organization, and less than 100 cases have been documented up to date in literature. The imaging features are not well known and to the best of our knowledge, there is not a radiology description of recurrence from tubulocystic renal cell carcinoma in the literature. We describe the case of a 70-year-old man with unusual cystic lesions in the left hypochondrium 11 years after a nephrectomy for tubulocystic renal cell carcinoma on the same side, and we report a review of the clinical characteristics of metastatic tubulocystic renal cell carcinoma.