Localized cystic disease of the kidney in pediatric patients: Clinical and imaging findings with long term follow up

  • Haesung Yoon
    Affiliations
    Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, South Korea
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  • Myung-Joon Kim
    Correspondence
    Correspondence to: Myung-Joon Kim, Department of Radiology, CHA Ilsan Medical Center, CHA University School of Medicine, 1205 Jungang-ro, Ilsandong-gu, Goyang, 10414, Republic of Korea, Tel.: +82 31 782 8644
    Affiliations
    Department of Radiology, CHA Ilsan Medical Center, CHA University School of Medicine, Goyang, South Korea
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  • Hyun Joo Shin
    Affiliations
    Department of Radiology and Research Institute of Radiological Science, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
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  • Mi-Jung Lee
    Affiliations
    Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, South Korea
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Published:November 11, 2021DOI:https://doi.org/10.1016/j.jpurol.2021.11.002

      Summary

      Introduction

      This study aimed to describe the clinical and imaging findings, including ultrasonography (US) findings, and long-term follow-up results in pediatric patients with localized cystic disease of the kidney (LCDK).

      Material and methods

      Retrospective review of pediatric patients diagnosed with LCDK based on imaging findings showing multiple localized renal cysts with intervening normal renal parenchyma from January 2002 to August 2020. Clinical presentations and US features of the affected and contralateral kidneys were reviewed and compared with computed tomography or magnetic resonance imaging findings, if available.

      Results

      A total of 18 patients (male:female = 11:7; median age, 8 years) were included. Initial clinical presentations were incidental findings (n = 5), abdominal pain (n = 5), or hematuria (n = 5). Of the seven patients (7/18, 39%) who showed multiple hyperechoic foci with ring-down artifacts within the cystic lesions on US, six patients showed focal calcification of the cysts on CT. Two patients (2/18, 11%) had milimetric cysts in the contralateral kidney. During follow-up (range, 2–122 months), there was an increase in lesion size, with ipsilateral renal growth in four patients (4/18, 22%). There was no renal function impairment at the initial presentation or during follow-up in all patients.

      Conclusions

      LCDK can present with milimetric calcifications (39%), contralateral milimetric renal cysts (11%), and mild size increase during renal growth (22%) in children without renal function impairment. Follow-up US is recommended without surgical intervention in these typical cases.

      Keywords

      Keywords

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