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Clinical significance of incidentally discovered renal cysts in pediatric patients

  • Ariel Botwin
  • Teerasak Phewplung
  • Kaiming Wu
  • Ruth Lim
  • Avram Z. Traum
  • Michael S. GeeEmail author
Kidneys, Ureters, Bladder, Retroperitoneum
  • 33 Downloads

Abstract

Purpose

To determine the clinical significance of incidentally discovered renal cysts in pediatric patients and identify imaging predictors of autosomal dominant polycystic kidney disease (ADPKD).

Methods

A retrospective search of radiology reports from 2000 to 2016 was performed to identify patients < 18 years old with an imaging exam identifying at least one renal cyst and a ≥ 1-year follow-up renal imaging exam for cyst evaluation and/or diagnosis of ADPKD. Cysts with clear solid mass components were excluded.

Results

84 pediatric patients with renal cysts were identified (mean age, 9.5 years), including 76 patients with incidentally discovered cysts and 8 patients with cysts identified from screening for ADPKD family history. Among the incidentally discovered cyst group, 7.9% were found to have ADPKD compared with 100% of patients with cysts and ADPKD family history. Maximum cyst diameter was significantly increased in patients with ADPKD compared to patients without ADPKD (22.0 mm vs 12.7 mm; P < 0.001, Fisher’s Exact test). Multiple cysts or bilateral cysts were imaging features associated with a significantly higher (P < 0.01) incidence of ADPKD, both for the entire study population and the incidentally discovered cyst group. An increase in cyst size on the follow-up study was associated with higher incidence of ADPKD (P < 0.05). No malignancies were identified.

Conclusions

Incidentally discovered renal cysts in pediatric patients are associated with a small but non-zero risk of ADPKD. Among cyst characteristics, bilaterality, multiplicity, large size, and increased size on follow-up imaging were associated with a statistically significant elevation of ADPKD risk, and should prompt diagnostic evaluation.

Keywords

Incidental Renal cyst Pediatric Imaging Autosomal dominant polycystic kidney disease Renal malignancy Ultrasound 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Ariel Botwin
    • 1
  • Teerasak Phewplung
    • 1
    • 2
  • Kaiming Wu
    • 1
  • Ruth Lim
    • 1
  • Avram Z. Traum
    • 3
  • Michael S. Gee
    • 1
    Email author
  1. 1.Department of RadiologyMassachusetts General Hospital and Harvard Medical SchoolBostonUSA
  2. 2.Department of Radiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Faculty of MedicineChulalongkorn UniversityBangkokThailand
  3. 3.Department of PediatricsBoston Children’s Hospital and Harvard Medical SchoolBostonUSA

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