technetium-tc-99m-sulfur-colloid and Kidney-Neoplasms

Heterotropic splenic tissue in renal fossa is characteristically asymptomatic and is usually an incidental finding that has been reported to mimic renal or adrenal tumors. A 55-year-old man with renal cell carcinoma had undergone radical nephrectomy together with splenectomy because of disrupture of the splenic capsule. During a follow-up examination, three nodules were detected by computed tomography scan in the splenorenal area and they slowly enlarged. Although local recurrence was highly suspected, we decided to rule out splenosis. We successfully diagnosed these masses as ectopic splenic tissues by a technetium sulfur colloid scan and unnecessary surgical exploration was avoided.

Topics: Carcinoma, Renal Cell; Diagnosis, Differential; Follow-Up Studies; Humans; Kidney Neoplasms; Male; Middle Aged; Neoplasm Recurrence, Local; Nephrectomy; Positron-Emission Tomography; Radiopharmaceuticals; Splenectomy; Splenosis; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

A renal mass was correctly identified with Tc-99m sulfur colloid liver-spleen scan and Tc-99m glucoheptonate scintigraphy while CT scan was misinterpreted as showing a hepatic lesion.

Topics: Aged; Carcinoma, Renal Cell; Diagnosis, Differential; Humans; Kidney Neoplasms; Liver Neoplasms; Male; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium; Technetium Tc 99m Sulfur Colloid

Two children being treated with combination chemotherapy and irradiation for localized, rightsided Wilms' tumor developed sudden enlargement of the liver with defects on liver scintigram resembling liver metastases. One child also developed pancytopenia. When chemotherapy was temporarily withheld in both children, hepatomegaly and scintigram abnormalities resolved. The planned courses of chemotherapy were subsequently completed without complications. The clinical course in our patients is compared to previously published experiences. Awareness of this complication could prevent the mistaken diagnosis of metastatic disease and emphasizes the care necessary when administering cytotoxic drugs to children receiving irradiation to all or a portion of the liver.

Topics: Antineoplastic Agents; Child, Preschool; Dactinomycin; Diagnostic Errors; Doxorubicin; Drug Therapy, Combination; Female; Hepatomegaly; Humans; Kidney Neoplasms; Liver Neoplasms; Male; Radionuclide Imaging; Radiotherapy Dosage; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Vincristine; Wilms Tumor