Clinically Very Important Rare Benign Renal Tumor: Presentation of a Renal Oncocytoma Case

Oncocytoma of the kidney was first described in 1942. The tumours are probably of proximal tubular epithelial origin and composed of oncocytes which are large epithelial cells with finely granular eosinophilic cytoplasm resulting from hypertrophied mitochondria.Most were being and 5–10 cm in diameter. They lack necrosis but may have central fibrosis.Peak incidence is in the seventh decade. Approximately 70% of oncocytomas are discovered as incidental findings,while 30% of patients may present flank pain, palpable renal mass, and gross or microscopic haematuria. Renal oncocytoma follows a benign clinical course.We report a right renal mass which was undistinguishable from renal cancer clinically but diagnosed as oncocytoma at the definitive pathological diagnosis.
65 yrs old man investigated for dull right flank pain lasting for more than 3 months.Renal ultrasonography revealed a right renal mass and CT examination confirms ultrasound by reporting a 10x8x6 cm solid mass located at the right kidney.Right radical nephrectomy was performed.Definitive pathology reported oncocytoma.Patient was discharged uneventfully.
There is no reliable preoperative diagnostic procedure distinguishing oncocytoma from renal carcinoma. The presence of a central stellate scar on CT or spoke wheel vascular pattern on renal arteriography may be suggestive of renal oncocytoma but these findings are also seen in some cases of renal carcinoma.We conclude that in the evaluation of an incidental renal mass the possibility of an oncocytoma should always be kept in mind and patients should be informed properly.

Klinik Olarak Çok Önemli Nadir Benign Renal Tümör: Renal Onkositom Olgu Sunumu

Böbrek onkositomu ilk olarak 1942 de tarif edilmiþtir. Proksimal tüplerin epitelinden köken aldýðý düþünülen ve hipertrofiye mitokondriler tarafýndan oluþturulan ince granüler eozinofilik sitoplazmalarý olan büyük epitelial hücreler olan onkositlerleden oluþan tümörlerdir. Çoðunlukla benign ve 5-10 cm çapýnda kitlelerdir. Nekroz içermezler ancak santral fibrozis vardýr. 7. dekatta en sýk görülürler. Yaklaþýk olarak %70 i insidental olarak saptanýrken, %30 u flank aðrýsý, palpabl renal kitle ve gross yada makroskobik hematüri ile semptom verirler. Renal onkositomanýn klinik seyri benigndir. Klinik olarak renal hücreli kanserden ayýrt edilemeyen ancak kesin patolojide onkositom olduðu saptanan bir vakayý sunduk.
Altmýþbeþ yaþýnda erkek hasta 3 aydan uzun süren künt sað yan aðrýsý nedeniyle kliniðimize baþvurdu. Renal ultrasonografide sað renal kitle saptandý. Bilgisayarlý tomografi (BT) incelemeside sað böbrek yerleþimli 10x8x6 cm lik solid kitle saptayarak Ultrasonografiyi doðruladý. Sað radikal nefrektomi yapýldý. Kesin patoloji raporu onkositom olarak geldi. Hasta sorunsuz olarak taburcu edildi.
Onkositomayý renal malign kitlelerden ayýracak güvenilir bir metod günümüzde yoktur.BT de kitle santralinde satelit skar görülmesi veya renal arteriografide at arabasý tekeri görüntüsü renal onkositomadan þüphelendirebilmekle birlikte ayný bulgular renal hücreli kanserlerde de görülebilmektedirler.Sonuç olarak insidental saptanan bir renal kitlenin taný ve tedavisi sýrasýnda onkositom olasýlýðý daima akýlda tutulmalý ve hastalar bu olasýlýk hakkýnda bilgilendirilmelidir.