Purpose: To investigate whether the presence and degree of peritumoral vascularity may provide any diagnostic information regarding the histological subtypes of renal tumors.
Materials and methods: Between January 2004 and March 2006, 214 patients (age, 19-94 years; 120 men, 94 women) with renal masses underwent total or partial nephrectomy and preoperative renal protocol computed tomography. Two radiologists retrospectively reviewed the computed tomographic exams in an independent and blinded fashion. The radiologists evaluated the presence of peritumoral vascularity and measured the largest vessel caliber. Fisher exact tests, multivariate logistic regression, and Wilcoxon rank-sum tests were performed for statistical analysis.
Results: Of 219 renal tumors (median size, 3.5 cm; range, 0.9-20.0 cm) included in this study, 112 (51%) were clear cell renal cell carcinoma, 34 (16%) were papillary, 32 (15%) were chromophobe, 17 (8%) were oncocytomas, 6 (3%) were lipid-poor angiomyolipomas, and 18 (8%) were other or unclassified renal tumors. The presence of peritumoral vascularity was significantly associated with tumor size within each subtype. For both readers, peritumoral vascularity was more frequently identified in clear cell carcinomas than in papillary renal carcinomas of similar size (P = 0.019 and 0.008, respectively). For one of the readers, chromophobe carcinomas were also significantly less frequently associated with peritumoral vascularity than clear cell carcinomas of similar size (P = 0.014).
Conclusions: Clear cell carcinomas demonstrate peritumoral vascularity significantly more frequently than other malignant renal tumors of similar size. The presence of peritumoral vascularity may provide additional diagnostic information and improve therapeutic planning in some cases.