Dilemmas in diagnosis and natural history of XXXX and implications for management.

@entity1 @entity8880 @entity1637 @entity1358 @entity3
INTRODUCTION: @entity1637 have traditionally been treated with surgical excision; however, their excellent long-term prognosis has popularized conservative and minimally invasive ablative techniques. We evaluated the evolving management and natural history of @entity8880 and investigated the relationship between radiological and histopathological diagnosis. METHODS: We performed a 17-year retrospective cohort study on all @entity1 with a confirmed histopathological diagnosis of @entity8880 . The primary outcome variables were long-term outcomes, coexistence with @entity1358 , and development of @entity3 . RESULTS: A total of 38 @entity1637 were reported in 36 @entity1 . Of the 36 @entity1 , 29 (81%) were diagnosed incidentally. @entity1637 was considered in the differential diagnosis in 4 @entity1637 (10.5%). In total, 34 @entity1 underwent early surgical intervention; of these, 27 (79.4%) underwent radical nephrectomy and 7 underwent partial nephrectomy (20.6%). Four @entity1 (11.1%) were managed conservatively with surveillance. No @entity1 developed recurrence or @entity3 after a median follow-up of 84 months (range: 4-178). CONCLUSIONS: The diagnostic accuracy for imaging modalities in @entity8880 is poor. Surveillance or minimally invasive ablative techniques are appropriate in selected @entity1 with biopsy-proven @entity1637 that are not increasing in size.
