Prediction of histopathological local staging by radiological findings and differential diagnosis overview in children with nephroblastoma

Background: Nephroblastoma is the most common renal malignancy in children kidney. They are highly heterogeneous tumors with challenging imagistic and histopathological (HP) differential diagnosis. Imaging is critical for understanding local anatomy, staging and for planning surgical approach. Purpose: To determine whether HP staging can be successfully predicted by the imagistic staging using computed tomography. Also, we find it important to make a brief review of the imagistic, HP and immunohistochemical differential diagnosis of nephroblastoma, considering that a correct diagnosis is essential for an appropriate therapeutic strategy in all stages. Patients, Materials and Methods: We present a retrospective study of the medical dossiers of 22 patients that underwent surgery at our Center between 2014 and 2020. We provided descriptive data and compared imagistic and HP staging using a Mann–Whitney U-test. An up-to-date literature review was also done. Results: We found that imagistic staging tends to under- or over-stage at similar rates and that the difference between the two staging systems is statistically significant. Immunohistochemistry is necessary for establishing the correct diagnosis, especially in cases with one predominant HP pattern. Conclusions: HP and imagistic staging are not yet sufficiently similar for successfully predict the former via imagistic means.