Estudio radiológico de un caso de pseudotumor sarcoideo renal bilateral / Bilateral kidney pseudotumor due to sarcoidosis: a radiological study case

OBJETIVO: Describir un caso de pseudotumor renal bilateral secundario a sarcoidosis en un paciente de 75 años en seguimiento por carcinoma de próstata y con historia de paquimeningitis hipertrófica. MÉTODOS: Se realizó ecografía-doppler abdominal, TC tóraco-abdomino-pélvico y biopsia renal guiada por TC, estudios analíticos, determinación de ECA y tratamiento de prueba con esteroides. RESULTADOS: En las pruebas de imagen se identificaron masa renales bilaterales y adenopatías mediastínicas calcificadas, insuficiencia renal y aumento de la ECA en la analítica y granulomas no caseificantes en la biopsia renal. Tanto la clínica neurológica como la función renal mejoraron con esteroides. CONCLUSIONES: La afectación renal pseudotumoral por sarcoidosis es una patología rara que debe incluirse en el diagnóstico diferencial de las masas renales, principalmente en pacientes con sospecha de enfermedad inflamatoria/autoinmune. Los hallazgos radiológicos del "sarcoide renal" son inespecíficos. Puede obtenerse biopsia guiada por TC/ecografía para diagnóstico histológico a partir de las masas renales(AU)

OBJECTIVE: To report one case of bilateral kidney pseudotumor due to sarcoidosis in a 75 year-old man with prostatic carcinoma and hypertrophic pachymeningitis. METHODS: Renal Doppler, body CT, CT-guided renal biopsy, blood analysis including angiotensin converting enzyme (ACE), blood levels and test-treatment (corticosteroid response) were performed. RESULTS: The radiological studies performed showed bilateral kidney masses and pulmonary calcified hilar adenopathies. Blood analysis showed renal failure and increased ACE levels. Renal biopsy showed non-caseating granulomas. Neurological symptoms and renal failure improved with corticosteroid therapy. CONCLUSION: Bilateral kidney pseudotumor due to sarcoidosis is a rare pathology. Sarcoidosis must be included in the differential diagnosis work up of patients with inflammatory or autoimmune disease and bilateral kidney pseudotumors. Radiological findings of kidney sarcoidosis are quite unspecific. Histological diagnosis with CT guided biopsy or US guided biopsy of kidney masses may be performed(AU)

Bilateral kidney pseudotumor due to sarcoidosis: a radiological study case.

OBJECTIVE: To report one case of bilateral kidney pseudotumor due to sarcoidosis in a 75 year-old man with prostatic carcinoma and hypertrophic pachymeningitis. METHODS: Renal Doppler, body CT, CT-guided renal biopsy, blood analysis including angiotensin converting enzyme (ACE), blood levels and test-treatment (corticosteroid response) were performed. RESULTS: The radiological studies performed showed bilateral kidney masses and pulmonary calcified hilar adenopathies. Blood analysis showed renal failure and increased ACE levels. Renal biopsy showed non-caseating granulomas. Neurological symptoms and renal failure improved with corticosteroid therapy. CONCLUSION: Bilateral kidney pseudotumor due to sarcoidosis is a rare pathology. Sarcoidosis must be included in the differential diagnosis work up of patients with inflammatory or autoimmune disease and bilateral kidney pseudotumors. Radiological findings of kidney sarcoidosis are quite unspecific. Histological diagnosis with CT guided biopsy or US guided biopsy of kidney masses may be performed.

Osteoid osteoma: CT-guided radiofrequency ablation.

Osteoid osteoma is a benign bone tumour; its main symptom is pain, which is sometimes resistant to analgesic or anti-inflammatory medication. The surgical treatment consists of en bloc excision or curettage of the lesion. Several alternative methods have been proposed, among which CT guided-percutaneous radiofrequency ablation. We report on ten patients who were diagnosed clinically and radiologically as presenting an osteoid osteoma and were treated with this technique, with more than two years follow-up. Results were uniformly excellent. The pain was relieved and the rate of post-operative complications was very low. We recommend percutaneous CT-guided radiofrequency ablation for the treatment of this lesion.