Overview
Solitary fibrous tumor of the kidney is a rare neoplasm characterized by its mesenchymal origin and potential for local invasion or metastasis, though it often presents as a benign lesion 1.Diagnosis
Imaging: Utilize multiphase postcontrast imaging for detailed characterization and surgical planning, particularly in complex cases like Wilms tumors 1.
Ultrasound: Confirm diagnosis and assess compensatory enlargement in pediatric solitary kidneys 2.
Urinalysis: Routinely performed at diagnosis for infants and children with compensatory enlargement 2.
Further Imaging: Avoid routine use beyond ultrasound if no additional urinary tract anomalies are detected 2.Management
Surgical Intervention: Primary treatment typically involves surgical resection, tailored based on imaging findings 1.
Follow-Up: Lifelong monitoring recommended for pediatric patients with solitary kidneys to assess growth and function 2.
Nutritional Guidance: Avoid excessive protein and salt intake to support kidney health 2.
Sports Participation: Consider individual risk assessment; allow participation in sports with informed consent regarding potential risks 3.Special Populations
Pediatrics: Focus on compensatory kidney growth and avoid unnecessary imaging beyond initial ultrasound 2.
Sports Participation: Decision varies; majority allow participation with risk discussion, though personal bias may influence decisions 3.Key Recommendations
Confirm diagnosis of solitary kidney in pediatric patients using neonatal ultrasound and avoid routine additional imaging unless other anomalies are present (Evidence: Moderate 2).
Perform urinalysis at diagnosis for infants and children with compensatory enlargement of the solitary kidney (Evidence: Moderate 2).
Allow sports participation for individuals with a solitary kidney after discussing potential risks, acknowledging variability in physician attitudes (Evidence: Weak 3).References
1 Silvestro E, Kolon TF, Canning D, Serai SD, Carson R, Sze R et al.. Pediatric Genitourinary 3D Modeling and Printing Using Multiphase Postcontrast Imaging Segmentation. Urology 2023. link
2 La Scola C, Ammenti A, Bertulli C, Bodria M, Brugnara M, Camilla R et al.. Management of the congenital solitary kidney: consensus recommendations of the Italian Society of Pediatric Nephrology. Pediatric nephrology (Berlin, Germany) 2022. link
3 Anderson CR. Solitary kidney and sports participation. Archives of family medicine 1995. link