Korean J Urol.  2013 Aug;54(8):504-509. 10.4111/kju.2013.54.8.504.

Usefulness of the Ice-Cream Cone Pattern in Computed Tomography for Prediction of Angiomyolipoma in Patients With a Small Renal Mass

• Kim KH
• Yun BH
• Jung SI
• Hwang IS
• Hwang EC
• Kang TW
• Kwon DD
• Park K
• Kim JW

• KMID: 1840461
• DOI: http://doi.org/10.4111/kju.2013.54.8.504

Abstract

PURPOSE
A morphologic contour method for assessing an exophytic renal mass as benign versus malignant on the basis of the shape of the interface with the renal parenchyma was recently developed. We investigated the usefulness of this morphologic contour method for predicting angiomyolipoma (AML) in patients who underwent partial nephrectomy for small renal masses (SRMs).
MATERIALS AND METHODS
From January 2004 to March 2013, among 197 patients who underwent partial nephrectomy for suspicious renal cell carcinoma (RCC), the medical records of 153 patients with tumors (AML or RCC) < or =3 cm in diameter were retrospectively reviewed. Patient characteristics including age, gender, type of surgery, size and location of tumor, pathologic results, and specific findings of the imaging study ("ice-cream cone" shape) were compared between the AML and RCC groups.
RESULTS
AML was diagnosed in 18 patients and RCC was diagnosed in 135 patients. Gender (p=0.001), tumor size (p=0.032), and presence of the ice-cream cone shape (p=0.001) showed statistically significant differences between the AML group and the RCC group. In the multivariate logistic regression analysis, female gender (odds ratio [OR], 5.20; 95% confidence interval [CI], 1.45 to 18.57; p=0.011), tumor size (OR, 0.34; 95% CI, 0.12 to 0.92; p=0.034), and presence of the ice-cream cone shape (OR, 18.12; 95% CI, 4.97 to 66.06; p=0.001) were predictors of AML.
CONCLUSIONS
This study confirmed a high incidence of AML in females. Also, the ice-cream cone shape and small tumor size were significant predictors of AML in SRMs. These finding could be beneficial for counseling patients with SRMs.

Keyword

Angiomyolipoma; Diagnostic imaging; Kidney; Nephrectomy; Renal cell carcinoma

MeSH Terms

Angiomyolipoma
Carcinoma, Renal Cell
Counseling
Diagnostic Imaging
Female
Humans
Incidence
Kidney
Logistic Models
Medical Records
Nephrectomy
Retrospective Studies

Figure

• 

  FIG. 1 Transverse abdominal computed tomography images showing two types of renal masses. A peripheral renal mass makes (A) an ice-cream cone pattern (angiomyolipoma) in the left kidney and (B) a round interface with the renal parenchyma (renal cell carcinoma) in the right kidney.

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