The diagnostic value of DMSA scan in differentiating functional pseudo-tumors from malignancies in scarred kidneys: case series and literature review
Abstract Background The terms “renal regenerating nodule” and “nodular compensatory hypertrophy” are used in the literature to describe functioning pseudo-tumors (FPT) in the setting of an extensively scarred kidney. FPTs are usually discovered incidentally during routine renal imaging. Differentiat...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-023-03113-5 |
| _version_ | 1797818147499147264 |
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| author | Enas Hussein Mohammed Ahmad Kaddourah Noor Al Khori Mehdi Djekidel |
| author_facet | Enas Hussein Mohammed Ahmad Kaddourah Noor Al Khori Mehdi Djekidel |
| author_sort | Enas Hussein Mohammed |
| collection | DOAJ |
| description | Abstract Background The terms “renal regenerating nodule” and “nodular compensatory hypertrophy” are used in the literature to describe functioning pseudo-tumors (FPT) in the setting of an extensively scarred kidney. FPTs are usually discovered incidentally during routine renal imaging. Differentiating these FPTs from renal neoplasms is critical but can be challenging in the setting of chronic kidney disease (CKD) given the limitations related to using contrast-based imaging. Case summaries We report a pediatric case series of 5 CKD patients, with history of urinary tract infections, in which tumor-like lesions evolved in scarred kidneys and were incidentally discovered on routine renal imaging. These were diagnosed as FPT by utilizing dimercaptosuccinic acid (DMSA) imaging and showed stable size and appearance upon follow-up with ultrasound and MRI. Conclusion FPTs can be picked up on routine imaging of pediatric patients with CKD. Although larger cohort studies are needed to confirm these conclusions, our case series supports the evidence that DMSA scan showing uptake at the site of the mass can be a useful tool to suggest the diagnosis of FPTs in children with kidney scarring, and that SPECT DMSA scan adds more precision in picking up and accurately localizing FPTs compared to planar DMSA. |
| first_indexed | 2024-03-13T09:03:41Z |
| format | Article |
| id | doaj.art-70113bcc62e544fcb6088efb7108986f |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-03-13T09:03:41Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-70113bcc62e544fcb6088efb7108986f2023-05-28T11:10:50ZengBMCBMC Nephrology1471-23692023-05-0124111010.1186/s12882-023-03113-5The diagnostic value of DMSA scan in differentiating functional pseudo-tumors from malignancies in scarred kidneys: case series and literature reviewEnas Hussein Mohammed0Ahmad Kaddourah1Noor Al Khori2Mehdi Djekidel3Department of Pediatrics, Division of Nephrology and Hypertension, Sidra MedicineDepartment of Pediatrics, Division of Nephrology and Hypertension, Sidra MedicineDepartment of Radiology, Division of Body Imaging, Sidra MedicineDepartment of Radiology, Division of Nuclear Medicine, NorthwellAbstract Background The terms “renal regenerating nodule” and “nodular compensatory hypertrophy” are used in the literature to describe functioning pseudo-tumors (FPT) in the setting of an extensively scarred kidney. FPTs are usually discovered incidentally during routine renal imaging. Differentiating these FPTs from renal neoplasms is critical but can be challenging in the setting of chronic kidney disease (CKD) given the limitations related to using contrast-based imaging. Case summaries We report a pediatric case series of 5 CKD patients, with history of urinary tract infections, in which tumor-like lesions evolved in scarred kidneys and were incidentally discovered on routine renal imaging. These were diagnosed as FPT by utilizing dimercaptosuccinic acid (DMSA) imaging and showed stable size and appearance upon follow-up with ultrasound and MRI. Conclusion FPTs can be picked up on routine imaging of pediatric patients with CKD. Although larger cohort studies are needed to confirm these conclusions, our case series supports the evidence that DMSA scan showing uptake at the site of the mass can be a useful tool to suggest the diagnosis of FPTs in children with kidney scarring, and that SPECT DMSA scan adds more precision in picking up and accurately localizing FPTs compared to planar DMSA.https://doi.org/10.1186/s12882-023-03113-5Renal regenerating nodule1Renal pseudo-tumor2Chronic kidney disease3Dimercaptosuccinic acid scanDMSA4Single photon emission computed tomography |
| spellingShingle | Enas Hussein Mohammed Ahmad Kaddourah Noor Al Khori Mehdi Djekidel The diagnostic value of DMSA scan in differentiating functional pseudo-tumors from malignancies in scarred kidneys: case series and literature review BMC Nephrology Renal regenerating nodule1 Renal pseudo-tumor2 Chronic kidney disease3 Dimercaptosuccinic acid scan DMSA4 Single photon emission computed tomography |
| title | The diagnostic value of DMSA scan in differentiating functional pseudo-tumors from malignancies in scarred kidneys: case series and literature review |
| title_full | The diagnostic value of DMSA scan in differentiating functional pseudo-tumors from malignancies in scarred kidneys: case series and literature review |
| title_fullStr | The diagnostic value of DMSA scan in differentiating functional pseudo-tumors from malignancies in scarred kidneys: case series and literature review |
| title_full_unstemmed | The diagnostic value of DMSA scan in differentiating functional pseudo-tumors from malignancies in scarred kidneys: case series and literature review |
| title_short | The diagnostic value of DMSA scan in differentiating functional pseudo-tumors from malignancies in scarred kidneys: case series and literature review |
| title_sort | diagnostic value of dmsa scan in differentiating functional pseudo tumors from malignancies in scarred kidneys case series and literature review |
| topic | Renal regenerating nodule1 Renal pseudo-tumor2 Chronic kidney disease3 Dimercaptosuccinic acid scan DMSA4 Single photon emission computed tomography |
| url | https://doi.org/10.1186/s12882-023-03113-5 |
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