A case series and literature review of renal anastomosing hemangioma: An often-misdiagnosed benign tumor

Abstract

Background: Renal anastomosing hemangiomas (RAHs) are rare. This study aimed to summarize the clinical, pathological, and imaging characteristics of RAH.

Materials and methods: We retrospectively analyzed 14 patients who underwent surgery for RAH at our center between December 2014 and December 2023. In addition, we conducted a literature review of case reports and case series on RAH published between 2009 and 2023.

Results: Renal anastomosing hemangioma predominantly affected men and was typically solitary. More than half of the tumors were localized in the renal parenchyma. Approximately 70.7% (65/92) of patients were asymptomatic. The mean maximum tumor diameter was 20 mm (range, 14-28 mm). A total of 35.2% (37/105) of patients had end-stage renal disease. Patients with end-stage renal disease and RAH are generally younger and have bilateral multifocal tumors. However, these tumors were smaller in size. Continent of origin of patient and tumor location were significant factors influencing tumor size. No tumor recurrence or distant metastases were observed during a median follow-up period of 18 months. Postoperative pathological staining remains the criterion standard for diagnosing RAH; however, preoperative multiparametric magnetic resonance imaging provides valuable diagnostic information. The RAH typically exhibits peripheral, discontinuous, and nodular enhancement during the corticomedullary phase, followed by centripetal fill-in enhancement during the excretory phase. Preoperative ultrasound-guided percutaneous biopsy is recommended when these characteristic magnetic resonance imaging features are observed.

Conclusions: Renal anastomosing hemangioma is a rare benign renal tumor that is often misdiagnosed on imaging, leading to potential overtreatment. Surgeons must be well versed in the differential diagnosis of tumors to provide optimal treatment for patients.

Keywords

Renal anastomosing hemangioma / Biological characteristics / Benign neoplasms / End-stage renal disease / Diagnostic imaging / Differential diagnosis

Acknowledgments

Not applicable.

Statement of ethics

This study was approved by the Medical Ethics Committee of Chinese PLA General Hospital (Internal Registration No. S2024-056-01). Informed consent was obtained from all 14 patients at our center. All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of interest statement

The authors declare that they have no competing interests.

Funding source

This study was funded by the National Natural Science Foundation of China (grant number 82273412).

Author contributions

JS, CP, XD, QH: Conceptualization;

JS, CP, HG, LM, XB, QJ, CS, NZ, XL, ZL: Formal analysis;

JS, CP, XD, YC, HK: Investigation;

JS, CP, XZ, XM, QH: Methodology;

XZ, XM, QH: Supervision;

JS, CP, XD, HG, YC: Writing, original draft;

JS, CP, XD, HK, QH: Writing, review and editing.

Data availability

The data sets analyzed in the current study are available from the corresponding author upon request.

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