Skip to main content
SpringerLink
Log in

Clinical significance of incidentally discovered renal cysts in pediatric patients

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Marietti S, Woldrich J, Durbin J, Sparks S, Kaplan G, Chiang G (2013) Urologic findings on computed tomography of the abdomen and pelvis in a pediatric population. Journal of pediatric urology 9 (5):609-612. doi:https://doi.org/10.1016/j.jpurol.2012.05.014

    Article  PubMed  Google Scholar 

  2. Torres VE, Harris PC, Pirson Y (2007) Autosomal dominant polycystic kidney disease. Lancet (London, England) 369 (9569):1287-1301. doi:https://doi.org/10.1016/s0140-6736(07)60601-1

    Article  Google Scholar 

  3. Dell KM (2011) The spectrum of polycystic kidney disease in children. Advances in chronic kidney disease 18 (5):339-347. doi:10.1053/j.ackd.2011.05.001

    Article  PubMed  PubMed Central  Google Scholar 

  4. Avni FE, Hall M (2010) Renal cystic diseases in children: new concepts. Pediatric radiology 40 (6):939-946. doi:https://doi.org/10.1007/s00247-010-1599-5

    Article  PubMed  Google Scholar 

  5. Ravine D, Gibson RN, Walker RG, Sheffield LJ, Kincaid-Smith P, Danks DM (1994) Evaluation of ultrasonographic diagnostic criteria for autosomal dominant polycystic kidney disease 1. Lancet (London, England) 343 (8901):824-827

    Article  CAS  Google Scholar 

  6. Rossetti S, Harris PC (2007) Genotype-phenotype correlations in autosomal dominant and autosomal recessive polycystic kidney disease. Journal of the American Society of Nephrology : JASN 18 (5):1374-1380. doi:https://doi.org/10.1681/asn.2007010125

    Article  CAS  PubMed  Google Scholar 

  7. Fujimaru T, Mori T, Sekine A, Mandai S, Chiga M, Kikuchi H, Ando F, Mori Y, Nomura N, Iimori S, Naito S, Okado T, Rai T, Hoshino J, Ubara Y, Uchida S, Sohara E (2018) Kidney enlargement and multiple liver cyst formation implicate mutations in PKD1/2 in adult sporadic polycystic kidney disease. Clinical genetics 94 (1):125-131. doi:https://doi.org/10.1111/cge.13249

    Article  CAS  PubMed  Google Scholar 

  8. McHugh K, Stringer DA, Hebert D, Babiak CA (1991) Simple renal cysts in children: diagnosis and follow-up with US. Radiology 178 (2):383-385. doi:https://doi.org/10.1148/radiology.178.2.1987597

    Article  CAS  PubMed  Google Scholar 

  9. Wallis MC, Lorenzo AJ, Farhat WA, Bagli DJ, Khoury AE, Pippi Salle JL (2008) Risk assessment of incidentally detected complex renal cysts in children: potential role for a modification of the Bosniak classification. The Journal of urology 180 (1):317-321. doi:https://doi.org/10.1016/j.juro.2008.03.063

    Article  PubMed  Google Scholar 

  10. Tada S, Yamagishi J, Kobayashi H, Hata Y, Kobari T (1983) The incidence of simple renal cyst by computed tomography. Clinical radiology 34 (4):437-439

    Article  CAS  PubMed  Google Scholar 

  11. Israel GM, Silverman SG (2011) The incidental renal mass. Radiologic clinics of North America 49 (2):369-383. doi:https://doi.org/10.1016/j.rcl.2010.10.007

    Article  PubMed  Google Scholar 

  12. Silverman SG, Israel GM, Herts BR, Richie JP (2008) Management of the incidental renal mass. Radiology 249 (1):16-31. doi:https://doi.org/10.1148/radiol.2491070783

    Article  Google Scholar 

  13. Karmazyn B, Tawadros A, Delaney LR, Marine MB, Cain MP, Rink RC, Jennings SG, Kaefer M (2015) Ultrasound classification of solitary renal cysts in children. Journal of pediatric urology 11 (3):149.e141-146. doi:https://doi.org/10.1016/j.jpurol.2015.03.001

    Article  Google Scholar 

  14. Bosniak MA (2012) The Bosniak renal cyst classification: 25 years later. Radiology 262 (3):781-785. doi:https://doi.org/10.1148/radiol.11111595

    Article  Google Scholar 

  15. Koutlidis N, Joyeux L, Mejean N, Sapin E (2015) Management of simple renal cyst in children: French multicenter experience of 36 cases and review of the literature. Journal of pediatric urology 11 (3):113-117. doi:https://doi.org/10.1016/j.jpurol.2015.03.003

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Ariel Botwin and Teerasak Phewplung have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA

    Ariel Botwin, Teerasak Phewplung, Kaiming Wu, Ruth Lim & Michael S. Gee

  2. Department of Radiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Pathum Wan, Bangkok, 10330, Thailand

    Teerasak Phewplung

  3. Department of Pediatrics, Boston Children’s Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA

    Avram Z. Traum

Authors
  1. Ariel Botwin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Teerasak Phewplung
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kaiming Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ruth Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Avram Z. Traum
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael S. Gee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael S. Gee.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Botwin, A., Phewplung, T., Wu, K. et al. Clinical significance of incidentally discovered renal cysts in pediatric patients. Abdom Radiol 44, 2835–2840 (2019). https://doi.org/10.1007/s00261-019-02017-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-019-02017-z

Keywords

Search

Navigation