Percutaneous aspiration and sclerosing therapy on the benign renal cyst

Choi, Ho Cheol; Park, Choal Hee; Kim, Chun Il

Abstract

Percutaneous treatment of benign renal cysts has been proposed as a method of reducing the morbidity associated with surgical treatment. The results of percutaneous aspiration and sclerosing therapy of 12 benign renal cysts and 5 infected renal cysts were reviewed. Percutaneous aspiration and daily sclerosing therapy with 99% ethanol for 4-5 days were performed in 12 benign renal cysts. Sclerosing therapy with 10% tetracycline solution following aspiration was done in the remaining 5 infected renal cysts. The aspirates were analyzed for color, total lipid, protein. lactic acid dehydrogenase (LDH). amylase. glucose and smear/culture. Also, cell block was performed for detection of malignant cells. All laboratory data were transudate except 5 infected renal cysts. Cytologic and bacteriological findings were negative except 1 infected renal cyst which had positive E. coli. All were followed by ultrasound or CT from 3 to 48 months (mean follow-up 26 months). In The 17 renal cysts, 9 cysts (53%) disappeared completely and 4 cysts (24%) decreased to half the original volume within 3 months period. In the 10 cysts who had been followed for 6 months. 4 cysts (40%) were collapsed completely and 2 cysts (20%) were reduced to half rhe original volume. The cystic cavity disappeared completely in 4 of 8 cysts (50%) and was decreased to half the original volume in 2 of 8 cysts (25%) for l year period. Overall efficacy was 71%. In summary, percutaneous aspiration and sclerosing therapy using 99% ethanol or 10% tetracycline solution was effective in the treatment of benign renal cysts and infected renal cysts. Also, differential diagnosis with malignant tumor was easily made by analysis of cystic fluid. In the recurred cysts, aspiration and sclerosing therapy were performed without significant complication and morbidity, repeatedly. But long-term follow-up evaluation will be necessary to document the results of aspiration with sclerosing therapy because of the diverse natural history of the renal cyst.