The diagnostic value of DMSA scan in differentiating functional pseudo-tumors from malignancies in scarred kidneys: case series and literature review

BMC Nephrology

Case Report

Enas Hussein Mohammed¹  Ahmad Kaddourah²  Noor Al Khori³  Mehdi Djekidel⁴ 

[1] Department of Pediatrics, Division of Nephrology and Hypertension, Sidra Medicine, Doha, Qatar;Department of Pediatrics, Division of Nephrology and Hypertension, Sidra Medicine, Doha, Qatar;Department of Pediatrics, Weill Cornel Medicine University, Doha, Qatar;Department of Radiology, Division of Body Imaging, Sidra Medicine, Doha, Qatar;Department of Radiology, Division of Nuclear Medicine, Northwell, New York, USA;

关键词: Renal regenerating nodule;    Renal pseudo-tumor;    Chronic kidney disease;    Dimercaptosuccinic acid scan;    DMSA;    Single photon emission computed tomography;    SPECT;    case series;   

DOI  :  10.1186/s12882-023-03113-5

 received in 2021-03-24, accepted in 2023-02-17,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe 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 summariesWe 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.ConclusionFPTs 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.

【 授权许可】

CC BY   
© The Author(s) 2023

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