CT of the kidneys: what size are renal cell carcinomas when they cause symptoms or signs?
OBJECTIVE
To investigate the size of renal cell carcinomas (RCCs) when they cause macroscopic hematuria or other symptoms and/or signs.


METHODS
A retrospective review of 232 patients (136 males, 96 females; mean age 68 +/- 11 years; age range 40-90 years) with a diagnosis of RCC was undertaken. Patients were grouped according to the presenting symptoms and/or signs caused by the RCCs. Tumor size was measured on CT images.


RESULTS
Of the RCCs, 29% were found incidentally and 71% caused symptoms and/or signs. The incidentally found RCCs measured 4.9 +/- 2.6 cm (range 2-12 cm) and RCCs causing symptoms and signs measured 8.9 +/- 3.2 cm (range 3-18 cm); this size difference was significant (p < 0.001). None of the RCCs causing macroscopic hematuria were <4 cm in size and only 3/165 (2%) of the symptomatic RCCs were <4 cm in size.


CONCLUSIONS
If small (<4 cm) RCCs do not cause symptoms, patients with them will not be referred for CT or any other imaging modality. Therefore, if a 2-cm RCC is found in a patient presenting with macroscopic hematuria, it is unlikely that this small RCC caused the hematuria and another cause of the hematuria must be ruled out.
Dahlman
Pär
P
Department of Radiology, Uppsala University Hospital, Uppsala, Sweden. par.dahlman@radiol.uu.se
Brekkan
Einar
E
Magnusson
Anders
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology; D007680:Kidney Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed