Computed tomography angiography alone cannot be used to accurately diagnose a disseminated renal tumor that closely resembles a renal artery aneurysm

Annals of vascular surgery. Brief reports and innovations Pub Date : 2024-03-27 DOI:10.1016/j.avsurg.2024.100270

Atsuyuki Mitsuishi , Takashi Karashima , Rie Yoshimura , Satoshi Fukata , Shinkuro Yamamoto

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Abstract

A 74-year-old woman underwent robot-assisted left partial nephrectomy for left renal cell carcinoma (RCC) at another hospital 5 years ago. However, the tumor recurred, and transarterial embolization (TAE) and radiofrequency ablation were planned. At finding of recurrence tumor, computed tomography angiography (CTA) also showed a left renal artery aneurysm (RAA). However, it was actually a disseminated tumor of RCC fed by the capsular artery, which was diagnosed by catheter-based angiography. Combined segmental artery resection was safely performed under robotic assistance. The pathological diagnosis was a recurrence of RCC. No continuity with the renal artery wall was observed, and vascular invasion was not evident. CTA is very useful in diagnosing RAA. However, CTA alone may lead to misdiagnosis. This paper reveals the pitfalls when diagnosing RAA with CTA. For accurate diagnosis, a combination of CTA and catheter-based angiography should be used.

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仅靠计算机断层扫描血管造影无法准确诊断与肾动脉瘤极为相似的播散性肾肿瘤

一名74岁的女性患者5年前因左肾细胞癌（RCC）在另一家医院接受了机器人辅助下的左肾部分切除术。然而，肿瘤复发了，于是计划进行经动脉栓塞（TAE）和射频消融术。发现肿瘤复发时，计算机断层扫描血管造影（CTA）也显示出左肾动脉瘤（RAA）。然而，导管血管造影确诊，这实际上是一个由囊动脉供血的RCC播散性肿瘤。在机器人辅助下，联合节段动脉切除术安全进行。病理诊断为 RCC 复发。未观察到与肾动脉壁的连续性，血管侵犯也不明显。CTA 对诊断 RAA 非常有用。但是，仅靠 CTA 可能会导致误诊。本文揭示了用 CTA 诊断 RAA 时的误区。为了准确诊断，应结合使用 CTA 和导管血管造影术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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