Clinicopathologic Patterns of Adult Renal Tumors in Pakistan

Abstract

Background: Renal cancer is a serious public health problem which may be under reported and registered in our setup, since the Karachi cancer registry documented only 43 cases out of 4,268 incident cancer cases over 3 year duration. Therefore we aimed to determine the clinicopathologic characteristics of adult renal tumors in our setup. Materials and Methods: The study was conducted in histopathology department, Liaquat National Hospital and included total of 68 cases of adult renal tumors over 4 years. Detailed histopathologic characteristics of tumors were analyzed. Results: Mean age of patients was 56.4 (18-84) years. Renal cell carcinoma (RCC) was the most common cell type (78%) cases; followed by transitional/urothelial carcinoma (12.5%), leiomyosarcoma (4.7%), oncocytoma (1.6%), squamous cell carcinoma (1.6%) and high grade pleomorphic undifferentiated sarcoma (1.6%). Among 50 RCC cases; 62% were conventional/clear cell RCC (CCRCC) type followed by papillary RCC(PRCC), 24%; chromophobe RCC(CRCC), 6% and sarcomatoid RCC(SRCC), 8%. Mean tumor size for RCC was 7.2 cm. Most RCCs were intermediate to high grade (60% and 40% respectively). Capsular invasion, renal sinus invasion, adrenal gland involvement and renal vein invasion was seen in 40%, 18%, 2% and 10% of cases respectively. Conclusions: We found that RCC presents at an earlier age in our setup compared to Western populations. Tumor size was significantly larger and most of the tumors were of intermediate to high grade. This reflects late presentation of patients after disease progression which necessitates effective measures to be taken in primary care setup to diagnose this disease at an early stage.

Clinicopathological study of adult malignant renal tumours in Kashmir

“…Furhman nuclear grade was applied only to clear cell RCC and tumours were grouped from grade I to grade IV. Majority of our tumours were in Grade II 44.44 and a similar trend was observed by Latif et al [19] and Hashmi et al [20].…”

“…In present study of 45 cases M:F ratio in our study was 4.6:1. Male preponderance was also noted in studies by Latif et al [l9] and Hashmi et al [20]. The peak incidence of RCC in this study was in the fourth and fifth decades of life, in contrast to other studies in the western world, where the majority of cases were in their sixth and seventh decades This could be because of the wide application of ultrasonography as screening tests in older age and prolonged life expectancy.…”

Renal cell carcinoma at the time of presentation: a 5-year radiological survey at a tertiary care cancer hospital

“…In a study done by Hashim et al in Southern Pakistan, the mean size of tumor was 7.2 cm which is in agreement with our study having a mean size of 7.1 cm in all the patients. 18 A study done in India by Agnihotri S et al, has presented the figure 8.08 cm as mean size of tumor and only 10.4% patients presented with tumor size less than 4 cm showing the late presentation with increased local spread. 19 In this study, renal vein invasion was present in 18 (12%) patients and 6 (4.02%) patients had inferior vena cava involvement.…”

Clinicopathological study of renal tumours in surgically excised specimens

“…In India, Renal Cell Carcinoma in luences the patients two decades earlier (Hashmi et al, 2014). In general, it is the twelfth most basic site of harm in men and seventeenth in ladies.…”