Experts Provide Guidance for Renal Masses in Pediatrics
(HealthDay News) — Renal tumors are rare in the pediatric population, and uncertainty surrounding pathology complicates management, according to a state-of-the-art review article published online December 1 in Pediatrics.
Alpin D. Malkan, MD, from the St. Jude Children's Research Hospital in Memphis, TN, and colleagues provide an overview of the spectrum of renal tumors in the pediatric population and their surgical management.
The authors note that pediatric renal cancers are rare, accounting for 6–7% of all childhood tumors. Distinguishing malignant neoplasms from benign masses is a key challenge, with both a thorough review of the patient's clinical history and a physician examination being useful for characterizing nonneoplastic renal pseudotumors. Computed tomography is usually necessary for confirmation of diagnosis. Histologic evaluation is the gold standard for pathologic diagnosis, but obtaining tissue biopsy can have serious implications: Open biopsies cause discomfort and scaring, while percutaneous needle biopsy cannot always differentiate renal lesions and can potentially upstage the tumor. Intervention for renal masses is justified in view of their significant effect. However, the rarity of these tumors, combined with uncertain malignant potential may lead to treatment that is too aggressive and unnecessary or too conservative.
"We encourage continued advancements in research to better define evidence-based approaches and treatment strategies for these challenging masses," the authors write.