[Can pharmaco-DSA of the kidney replace intraoperative rapid biopsy diagnosis?].
OBJECTIVE
Can primary nephrectomy be performed without preliminary sample excision of the tumor if pharmaco-angiography of the kidney has demonstrated the typical tumor vascularization?


METHODS
To clarify this question in 32 patients with "displacing mass" of the kidney, verified in sonography and computer-tomography, or hematuria of unknown origin, we prospectively performed and additional pharmaco-angiography of the respective kidney.


RESULTS
In 18 patients with tumor vascularization in the pharmaco-angiography, intraoperatively we found 15 malignant renal cell carcinomas, 1 patient with transitional cell carcinoma of the renal pelvis, 1 leiomyosarcoma, and 1 high-differentiated tumor of only 2 cm in diameter with unclear dignity, which was treated by enucleation.


CONCLUSIONS
In case of an intrarenal lesion of more than 3 cm in diameter and additional tumor vascularization seen in selective pharmaco-angiography, the kidney undoubtedly can be removed by primary nephrectomy without a preliminary sample excision to confirm the diagnosis. For tumors with a diameter of less than 3 cm and additional tumor-vascularization, the option should be enucleation. If there is a "tumor" without typical malignant vascularization, the exploration by sample excision should be performed. Depending on the histological result the tumor should be removed by enucleation or nephrectomy.
Will
C H
CH
Abt. für Strahlendiagnostik, St.-Agnes-Hospital Bocholt.
Bach
D
D
Koop
H
H
Impekoven
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D004837:Epinephrine; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000473:pathology; D007680:Kidney Neoplasms / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012680:Sensitivity and Specificity
D004837:Epinephrine
Kann die Pharmako-DSA der Niere die intraoperative Schnellschnittdiagnostik ersetzen?