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Introduction: Renal Cell Carcinoma (RCC) is a tumor derived from the renal tubular epithelium, representing approximately 90% of malignant kidney neoplasms, and it has a radiological presentation as a nodule with varying enhancement on sectional diagnostic methods. It can be asymptomatic, with diagnosis often made through imaging studies performed for other reasons. Oncocytoma is a benign tumor that has a radiological presentation similar to RCC, accounting for approximately 4 to 10% of nephrectomies resulting from an initial suspicion of RCC. Objective: This study aims to report a case of Kidney Incidentaloma in a patient suspected of Covid-19.
Methods: The medical history was collected, abdominal ultrasound, chest computed tomography (CT) and abdominal CT examinations were reviewed with the aim of creating a case report.
Results: A 63-year-old female patient with clinical symptoms suspicious for viral pneumonia during the SARS-CoV-2 pandemic in 2020 underwent a CT for diagnosis, screening, and staging of the severity of the viral pulmonary inflammatory-infectious process. As an additional finding, a nodular lesion with indeterminate isodense configuration in the right kidney was observed, which constituted an incidentaloma and led to further diagnostic investigation. A urinary system ultrasound (USG) confirmed the finding of a solid renal nodule, correlating with a hypervascularized solid nodule, minimally exophytic and infiltrating the renal sinus fat, as identified in a contrast-enhanced Abdominal Computed Tomography study performed subsequently. The patient underwent partial nephrectomy, with a histopathological report of oncocytoma.
Discussion: Oncocytoma is a rare benign tumor located in the kidneys, which shares clinical, histopathological, and radiological similarities with renal carcinoma, not necessarily requiring surgical intervention. The patient underwent partial nephrectomy, with an anatomopathological report revealing two nodular lesions measuring 3.5 x 2.5 x 2.2 cm and 0.8 x 0.7 x 0.6 cm, soft in consistency, brownish in color, and well-demarcated, the smaller one with slight hemorrhage, consistent with a diagnosis of oncocytoma. The radiological presentation similar to RCC and the lower incidence of benign renal tumors contribute to surgical intervention in the management of solid renal nodular lesions, while active surveillance could be an alternative for benign tumors. In recent years, studies have shown the benefits of using artificial intelligence as an additional tool in differentiating oncocytoma from renal carcinoma, potentially reducing unnecessary nephrectomies. Conclusions: This case highlights the importance of imaging methods in managing incidentalomas, which are lesions discovered incidentally in imaging studies requested for other purposes. Improved diagnostic accuracy of imaging methods through artificial intelligence can contribute to the reduction of invasive surgical procedures.