Fact-sheet: Oncocytoma


Updated on 10/11/2024 at 3:45 PM

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Definition

Oncocytoma (or oncocytic adenoma) is a rare benign kidney tumor arising from the intercalated cells of the collecting tubules.

Cause: mitochondrial DNA mutation, translocation, chromosomal deletions

Clinical features

  • Accounts for approximately 5% of all renal tumors.
  • Mean age at discovery: 65 years
  • Slight male predominance (ratio of 2-3:1).
  • Typically asymptomatic, which explains a mean size at diagnosis of 7 cm
  • Occasionally revealed by hypertension

Ultrasound

  • Hypoechoic solid lesion.
  • Central scar sometimes visible

CT

  • Solitary lesion, often large (3-10 cm)
  • Encapsulated lesion
  • Lesion iso- or hyperdense relative to the Kidney
  • Central scar (30% of cases)
  • Centrifugal spoke-wheel enhancement pattern on the arterial phase
  • Homogenization on the parenchymal phase
  • No lymphadenopathy, metastasis, or peripheral invasion

MRI

  • T1: hypo- or isointense
  • T2: hyperintense
  • Gadolinium: intense enhancement with a spoke-wheel pattern, followed by signal homogenization on the parenchymal phase.
  • No lymphadenopathy, metastasis, or peripheral invasion

Nuclear medicine

No difference in uptake compared with the adjacent renal parenchyma.

Management

Surgical resection
Definitive histologic diagnosis

Differential diagnosis

  • Renal cell carcinoma
  • Angiomyolipoma
  • Renal metastases
  • Lymphoma of kidney