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Cisto multilocular renal

Multilocular cyst of the kidney

Resumos

O cisto multilocular renal é uma tumoração rara, de etiopatogenia discutida, que apresenta um aspecto macroscópico característico (parecendo favos de mel) mas histologia variável, o que ocasionou uma vasta sinonímia para esta afecção. Com os modernos métodos de diagnóstico por imagem, estes tumores podem ser suspeitados no pré-operatório, mas antes eram rotulados como provável nefroblastoma (Tumor de Wilms). Os autores descrevem as características de cinco casos observados nos Serviços de Cirurgia Pediátrica dos Hospitais Getúlio Vargas e da Lagoa, do Rio de Janeiro, e no Hospital Universitário de João Pessoa (Paraíba). Em todos, o sintoma predominante era uma massa abdominal, mas em um havia também hipertensão arterial. Todos os pacientes foram submetidos a nefrectomia e tiveram boa evolução pós-operatória. Apesar de pouco freqüente, o cisto multilocular renal deve ser lembrado no diagnóstico de qualquer massa renal em crianças, especialmente naquelas com menos de dois anos de idade, devido ao prognóstico favorável em comparação com o do tumor de Wilms. No adulto, o diagnóstico diferencial é feito principalmente com o adenocarcinoma cístico.

Cistos renais; Tumor de Wilms


The multilocular cyst of the Kidney is a rare tumoration, of disputable ethiopatogeny, with typical macroscopic characteristics (looking as honeycomb), but variable histology, generating a lot of synonyms. With the modern image diagnostic methods, these tumors may be suspected pre-operatorily. Previously they were rotulated as probable nephroblastoma (Wilm's tumor). The authors describe the aspects of five cases observed at Pediatric Surgery Services of Getulio Vargas and Lagoa Hospitals of Rio de Janeiro, and University Hospital of João Pessoa (Paraíba). In all of these cases the predominate synptom was a abdominal mass, but one of them also showed arterial hypertension. The five pacients were nephrectomized with a good pos-operatory evolution. In despite of its low incidency, the CMR must be remembered in the diagnosis of any renal mass of infancy, because of favourable diagnosis related to the Wilm's tumor. At adult hood, the differential diagnosis is made mostly with the cystic adenocarcinoma.

Kidney cysts; Wilm's tumor


ARTIGOS ORIGINAIS

Cisto multilocular renal

Multilocular cyst of the kidney

Ennio Gabriel, TCBC-RJI; Wilberto TrigueiroII; Dailton MedeirosIII; Vamberto Costa FilhoIV; Sandra Bonfim Silva BarbosaV; Alexandre Aranha TrigueiroVI

ICirurgião Pediátrico do Hospital da Lagoa. Livre-Docente pela Universidade Federal Fluminense

IIProfessor Adjunto de Cirurgia Pediátrica da Universidade Federal da Paraíba

IIIChefe do Serviço de Anatomia Patológica do Hospital da Lagoa

IVMédico Radiologista do Hospital Universitário da Paraíba

VEx-Residente do Hospital da Lagoa

VIResidente de Cirurgia Geral do Hospital Universitário da Paraíba

Endereço para correspondência Endereço para correspondência: Dr. Ennio Gabriel Rua Roberto Dias Lopes, 25/1.401 22010-110 - Rio de Janeiro-RJ

RESUMO

O cisto multilocular renal é uma tumoração rara, de etiopatogenia discutida, que apresenta um aspecto macroscópico característico (parecendo favos de mel) mas histologia variável, o que ocasionou uma vasta sinonímia para esta afecção. Com os modernos métodos de diagnóstico por imagem, estes tumores podem ser suspeitados no pré-operatório, mas antes eram rotulados como provável nefroblastoma (Tumor de Wilms). Os autores descrevem as características de cinco casos observados nos Serviços de Cirurgia Pediátrica dos Hospitais Getúlio Vargas e da Lagoa, do Rio de Janeiro, e no Hospital Universitário de João Pessoa (Paraíba). Em todos, o sintoma predominante era uma massa abdominal, mas em um havia também hipertensão arterial. Todos os pacientes foram submetidos a nefrectomia e tiveram boa evolução pós-operatória. Apesar de pouco freqüente, o cisto multilocular renal deve ser lembrado no diagnóstico de qualquer massa renal em crianças, especialmente naquelas com menos de dois anos de idade, devido ao prognóstico favorável em comparação com o do tumor de Wilms. No adulto, o diagnóstico diferencial é feito principalmente com o adenocarcinoma cístico.

Unitermos: Cistos renais; Tumor de Wilms.

ABSTRACT

The multilocular cyst of the Kidney is a rare tumoration, of disputable ethiopatogeny, with typical macroscopic characteristics (looking as honeycomb), but variable histology, generating a lot of synonyms. With the modern image diagnostic methods, these tumors may be suspected pre-operatorily. Previously they were rotulated as probable nephroblastoma (Wilm's tumor). The authors describe the aspects of five cases observed at Pediatric Surgery Services of Getulio Vargas and Lagoa Hospitals of Rio de Janeiro, and University Hospital of João Pessoa (Paraíba). In all of these cases the predominate synptom was a abdominal mass, but one of them also showed arterial hypertension. The five pacients were nephrectomized with a good pos-operatory evolution. In despite of its low incidency, the CMR must be remembered in the diagnosis of any renal mass of infancy, because of favourable diagnosis related to the Wilm's tumor. At adult hood, the differential diagnosis is made mostly with the cystic adenocarcinoma.

Key words: Kidney cysts; Wilm's tumor.

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Full text available only in PDF format.

REFERÊNCIAS

1. Nairn ERK, Tudway OC, O'Brien JM, et al. Multilocular cystic nephroma. Brit J Urol 1990; 65;543-544.

2. Fobi M, Mahour GH, Isaacs H Jr. Multilocular cyst of the kidney. J Pediat Surg 1979;14:282-286.

3. Lhez JM, Joffre F, Escourrou G. Kyste multiloculaire du rein. J Urologie 1980;86:709-712.

4. Sharp RJ. Developmental anomalies of the kidney. In Ashcraft KW- Pediatric Urology. Philadelphia, WB Saunders Company, 1990; pg. 77-115.

5. Souza ECC, Verona CBM, Suzigan S, et al. Nefroma cístico multilocular - relato de 2 casos. Radiol Bras 1988 ;21: 193-196.

6. Baldauf M, Schulz D. Multilocular cyst of the kidney. Amer J Clin Pathol 1976;65:93-102.

7. Steiner A, Farkash T, Scheinfeld A. Kyste solitaire multiloculaire du rein. J Chir (Paris) 1970; 99:535-540.

8. Uson A, Melicow M. Multilocular cysts of kidney with intrapelvic herniation of "daughter"cyst: report of 4 cases. J Urol 1963; 89: 341-348.

9. Chadarévian JP de, Punnett HH, Billmire DF, et al. Hyperploidy and trisomy 12 in the cystic partially differentiated nephroblastorna. Hum Pathol 1996;27:980-981.

10. Powell T, Shackrnan RJ, Johnson H. Multilocular cysts of the kidney. Brit J Uro/1951;23:142-!52.

11. Boggs L, Kimmestiel P. Benign multilocular cystic nephrorna: report of two cases of so-called multilocular cyst of the kidney. J Urol 1956; 76:530-541.

12. Chatten J, Bishop HC. Bilateral rnultilocular cysts of the kidneys. J Pediat Surg 1977;12:749-750.

13. Egerdie R, Buckspan M, Klotz P, et al. Bilateral multilocular renal cysts. J Urol 1986;135:346-348.

14. Joshi VV, Beckwith JB. Multilocular cyst of the kidney (cystic nephroma) and cystic partially differentiated nephroblastorna. Cancer 1989;64:466-479.

15. Faria P, Zerbini MC. Dedifferentiated cystic nephroma with malignant mesenchymoma as the dedifferentiated component. Pediat Pathol Lab Med 1996; 16:1.003-1.011.

16. Frazier T. Multilocularcyst of the kidney. J Urol 1951; 65:351-363.

17. Glassberg KI, Filmer B. Renal dysplasia, renal hypoplasia and cystic disease of the kidney. In Kelalis PP, King LR, Belman AB - Clínical Pediatric Urology. Philadelphia, WB Saunders Company, 3ª ed., 1992, pp. 1121-1184.

18. Prevot J, Rauber G, Bretagne M, Hummer J. Kystes multiloculaires du rein chez l'enfant. Annales Chir Infantile 1973;14:377-384.

19. Hirai T, Ohishi H, Yamada R, et al. Usefulness of colar doppler flow imaging in differential diagnosis of multilocular cystic lesions of the kidney. J Ultrassound Med 1995;14:771-776.

20. Minevich E, Wacksman J, Phipps L, et al. The importance of accurate diagnosis and early close follow-up in patients with suspected multicystic dysplastic kidney. J Urol 1997; 158 (3 pt.2):1.301-1.304.

21. Streif W, Gassner I, Janetschek G, et al. Partial nephrectomy in a cystic partially differentiated nephroblastoma. Med Pediat Oncol 1997; 28:416-419.

Recebido em 4/1/98

Aceito para publicação em 20/5/99

Trabalho dos Serviços de Cirurgia Pediátrica dos Hospitais da Lagoa e Getúlio Vargas (RJ), e Universitário de João Pessoa (PB).

  • 1. Nairn ERK, Tudway OC, O'Brien JM, et al. Multilocular cystic nephroma. Brit  J Urol 1990; 65;543-544.
  • 2. Fobi M, Mahour GH, Isaacs H Jr. Multilocular cyst of the kidney. J Pediat Surg 1979;14:282-286.
  • 3. Lhez JM, Joffre F, Escourrou G. Kyste multiloculaire du rein. J Urologie 1980;86:709-712.
  • 4. Sharp RJ. Developmental anomalies of the kidney. In Ashcraft KW- Pediatric Urology. Philadelphia, WB Saunders Company, 1990; pg. 77-115.
  • 5. Souza ECC, Verona CBM, Suzigan S, et al. Nefroma cístico multilocular - relato de 2 casos. Radiol Bras 1988 ;21: 193-196.
  • 6. Baldauf M, Schulz D. Multilocular cyst of the kidney. Amer J Clin Pathol 1976;65:93-102.
  • 7. Steiner A, Farkash T, Scheinfeld A. Kyste solitaire multiloculaire du rein.  J Chir (Paris) 1970; 99:535-540.
  • 8. Uson A, Melicow M. Multilocular cysts of kidney with intrapelvic herniation of "daughter"cyst: report of 4 cases. J Urol 1963; 89: 341-348.
  • 9. Chadarévian JP de, Punnett HH, Billmire DF, et al. Hyperploidy and trisomy 12 in the cystic partially differentiated nephroblastorna. Hum Pathol 1996;27:980-981.
  • 10. Powell T, Shackrnan RJ, Johnson H. Multilocular cysts of the kidney. Brit J Uro/1951;23:142-!52.
  • 11. Boggs L, Kimmestiel P. Benign multilocular cystic nephrorna: report of two cases of so-called multilocular cyst of the kidney. J Urol 1956; 76:530-541.
  • 12. Chatten J, Bishop HC. Bilateral rnultilocular cysts of the kidneys. J Pediat Surg 1977;12:749-750.
  • 13. Egerdie R, Buckspan M, Klotz P, et al. Bilateral multilocular renal cysts. J Urol 1986;135:346-348.
  • 14. Joshi VV, Beckwith JB. Multilocular cyst of the kidney (cystic nephroma) and cystic partially differentiated nephroblastorna. Cancer 1989;64:466-479.
  • 15. Faria P, Zerbini MC. Dedifferentiated cystic nephroma with malignant mesenchymoma as the dedifferentiated component. Pediat Pathol Lab Med 1996; 16:1.003-1.011.
  • 16. Frazier T. Multilocularcyst of the kidney. J Urol 1951; 65:351-363.
  • 17. Glassberg KI, Filmer B. Renal dysplasia, renal hypoplasia and cystic disease of the kidney. In Kelalis PP, King LR, Belman AB - Clínical Pediatric Urology. Philadelphia, WB Saunders Company, 3Ş ed., 1992, pp. 1121-1184.
  • 18. Prevot J, Rauber G, Bretagne M, Hummer J. Kystes multiloculaires du rein chez l'enfant. Annales Chir Infantile 1973;14:377-384.
  • 19. Hirai T, Ohishi H, Yamada R, et al. Usefulness of colar doppler flow imaging in differential diagnosis of multilocular cystic lesions of the kidney. J Ultrassound Med 1995;14:771-776.
  • 20. Minevich E, Wacksman J, Phipps L, et al. The importance of accurate diagnosis and early close follow-up in patients with suspected multicystic dysplastic kidney. J Urol 1997; 158 (3 pt.2):1.301-1.304.
  • 21. Streif W, Gassner I, Janetschek G, et al. Partial nephrectomy in a cystic partially differentiated nephroblastoma. Med Pediat Oncol  1997; 28:416-419.
  • Endereço para correspondência:
    Dr. Ennio Gabriel
    Rua Roberto Dias Lopes, 25/1.401
    22010-110 - Rio de Janeiro-RJ
  • Datas de Publicação

    • Publicação nesta coleção
      26 Jan 2010
    • Data do Fascículo
      Jun 1999

    Histórico

    • Aceito
      20 Maio 1999
    • Recebido
      04 Jan 1998
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