Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2024; 12(14): 2332-2341
Published online May 16, 2024. doi: 10.12998/wjcc.v12.i14.2332
Clinicopathological characteristics and typing of multilocular cystic renal neoplasm of low malignant potential
Wen-Long Gao, Gang Li, Dong-Sheng Zhu, Yuan-Jie Niu
Wen-Long Gao, Gang Li, Yuan-Jie Niu, Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
Dong-Sheng Zhu, Department of Pediatric Surgery, The First People’s Hospital of Lianyungang, Lianyungang 222000, Jiangsu Province, China
Co-first authors: Wen-Long Gao and Gang Li.
Co-corresponding authors: Dong-Sheng Zhu and Yuan-Jie Niu.
Author contributions: Niu YJ, Zhu DS, Gao WL, and Li G conceptualized and designed the research; Gao WL, and Li G screened patients and acquired clinical data; Niu YJ, Zhu DS contributed new reagents/analytic tools; Zhu DS, Gao WL, and Li G performed Data analysis; Gao WL and Li G wrote the paper. All the authors have read and approved the final manuscript. Gao WL proposed, designed and conducted the research, performed data analysis and prepared the first draft of the manuscript. Li G was responsible for patient screening, enrollment and collection of clinical data. Both authors have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper. Both Niu YJ and Zhu DS have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors. Niu YJ applied for and obtained the funds for this research project. Niu YJ conceptualized, designed, and supervised the whole process of the project. Zhu DS searched the literature, revised and submitted the early version of the manuscript with the focus on the clinicopathological characteristics and typing of multilocular cystic renal neoplasm of low malignant potential. Zhu DS was instrumental and responsible for data re-analysis and re-interpretation, figure plotting, comprehensive literature search, preparation and submission of the current version of the manuscript with a new focus on the correlation between CT imaging, growth rate and effective management strategies of MCRNLMP. This collaboration between Niu YJ and Zhu DS is crucial for the publication of this manuscript and other manuscripts still in preparation. Zhu DS was designated as the corresponding author responsible for contact.
Supported by Tianjin Municipal Natural Science Foundation, No. 21JCYBJC01690.
Institutional review board statement: The study was reviewed and approved by the Second Hospital of Tianjin Medical University Institutional Review Board [(Approval No. KY2020A268]).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Data sharing statement: Obtained from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Jie Niu, MD, Doctor, Department of Urology, The Second Hospital of Tianjin Medical University, No. 23 Pingjiang Road, Tianjin 300211, China. yuanjieniu01@outlook.com
Received: January 12, 2024
Revised: February 18, 2024
Accepted: April 2, 2024
Published online: May 16, 2024
Abstract
BACKGROUND

Up until now, no research has been reported on the association between the clinical growth rate of multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) and computed tomography (CT) imaging characteristics. Our study sought to examine the correlation between them, with the objective of distinguishing unique features of MCRNLMP from renal cysts and exploring effective management strategies.

AIM

To investigate optimal management strategies of MCRNLMP.

METHODS

We retrospectively collected and analyzed data from 1520 patients, comprising 1444 with renal cysts and 76 with MCRNLMP, who underwent renal cyst decompression, radical nephrectomy, or nephron-sparing surgery for renal cystic disease between January 2013 and December 2021 at our institution. Detection of MCRNLMP utilized the Bosniak classification for imaging and the 2016 World Health Organization criteria for clinical pathology.

RESULTS

Our meticulous exploration has revealed compelling findings on the occurrence of MCRNLMP. Precisely, it comprises 1.48% of all cases involving simple renal cysts, 5.26% of those with complex renal cysts, and a noteworthy 12.11% of renal tumors coexisting with renal cysts, indicating a statistically significant difference (P = 0.001). Moreover, MCRNLMP constituted a significant 22.37% of the patient population whose cysts demonstrated a rapid growth rate of ≥ 2.0 cm/year, whereas it only represented 0.66% among those with a growth rate below 2.0 cm/year. Of the 76 MCRNLMP cases studied, none of the nine patients who underwent subsequent nephron-sparing surgery or radical nephrectomy following renal cyst decompression experienced recurrence or metastasis. In the remaining 67 patients, who were actively monitored over a 3-year postoperative period, only one showed suspicious recurrence on CT scans.

CONCLUSION

MCRNLMP can be tentatively identified and categorized into three types based on CT scanning and growth rate indicators. In treating MCRNLMP, partial nephrectomy is preferred, while radical nephrectomy should be minimized. After surgery, active monitoring is advisable to prevent unnecessary nephrectomy.

Keywords: Renal cysts, Multilocular cystic renal neoplasm of low malignant potential, Computed tomography, Diagnosis, Treatment

Core Tip: A rather uncommon type of renal cell carcinoma, multilocular cystic renal neoplasm of low malignant potential (MCRNLMP), exhibits distinct clinicopathological traits and often has a good prognosis. Although it bears resemblances to clear cell renal cell carcinoma in terms of clinical manifestations, pathology, diagnosis, and therapeutic approaches, there are notable differences as well. Despite ongoing discussions regarding the best practices for diagnosing and treating MCRNLMP, it is essential for clinicians to take into account its imaging features alongside other pertinent clinical considerations. This holistic approach should encompass selecting tailored treatment options and determining optimal follow-up schedules.