Mp56-18 Descriptive Report of Complex Cystic Renal Mass Fluid Cytology

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (MP56)1 May 2024MP56-18 DESCRIPTIVE REPORT OF COMPLEX CYSTIC RENAL MASS FLUID CYTOLOGY Francis A. Jefferson, Gang Zheng, Sounak Gupta, Matthew S. Lee, Amber R. Schneider, Valerie M. Straubmuller, Tal D. Cohen, George K. Chow, and Aaron M. Potretzke Francis A. JeffersonFrancis A. Jefferson , Gang ZhengGang Zheng , Sounak GuptaSounak Gupta , Matthew S. LeeMatthew S. Lee , Amber R. SchneiderAmber R. Schneider , Valerie M. StraubmullerValerie M. Straubmuller , Tal D. CohenTal D. Cohen , George K. ChowGeorge K. Chow , and Aaron M. PotretzkeAaron M. Potretzke View All Author Informationhttps://doi.org/10.1097/01.JU.0001008940.44711.d4.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: During surgical extirpation of cystic renal masses, surgeons universally attempt to avoid cyst rupture due to the risk of tumor seeding. Whether the concern regarding tumor seeding is warranted is debatable. Our objective was to evaluate for the presence of malignant cells in the fluid of complex renal cysts. METHODS: This was a prospective study of consecutive adult patients undergoing open or minimally invasive radical or partial nephrectomy of a clinically localized cystic renal mass. Following excision, fluid from the mass was aspirated and sent for cytologic analysis. Cyst fluid was prepared by splitting the collected fluid in half and processing up to 50 mls into a PreservCyt® Vial on a ThinPrep® 2000 or ThinPrep® 5000 processor using standard protocols resulting in a pap-stained ThinPrep glass slide. The second half of the fluid was processed into a cellblock using a plasma/thrombin process resulting in an FFPE block cut to produce an H&E-stained slide. Both the pap-stained and H&E slides are evaluated for cells. RESULTS: Twenty-one patients underwent resection of 22 cystic tumors. Median (IQR) tumor diameter was 3.7 cm (3.0–5.0 cm; Table 1). On preoperative cross-sectional imaging, tumors were most often described as having the appearance of cystic renal cell carcinoma (RCC) (n=8, 36%) or Bosniak 4 lesions (n=6, 28%). Most patients underwent robotic partial nephrectomy (n=17, 81%). Renal cyst cytology was benign in 50% (n=11) of tumors, atypical in 32% (n=7), suspicious in 9% (n=2), and positive for malignancy in 9% (n=2). Clear cell RCC (ccRCC) was the most common histologic subtype (n=15, 68%). Of the positive cytologic specimens, one correlated with a final histology of ccRCC while the other returned as metanephric adenoma. CONCLUSIONS: Based on routine cytologic analysis, there is no clear pattern with presence or absence of malignant cells in the fluid of complex renal cysts. More sophisticated testing may provide insight into the malignant potential of renal cyst fluid. This information would prove useful in postoperative surveillance in the event of intraoperative cyst rupture. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e934 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Francis A. Jefferson More articles by this author Gang Zheng More articles by this author Sounak Gupta More articles by this author Matthew S. Lee More articles by this author Amber R. Schneider More articles by this author Valerie M. Straubmuller More articles by this author Tal D. Cohen More articles by this author George K. Chow More articles by this author Aaron M. Potretzke More articles by this author Expand All Advertisement PDF downloadLoading ...