Renal cell carcinoma: earlier discovery and increased detection.

Abstract

To document the earlier discovery and increased detection of renal cell carcinoma, the authors reviewed cases of renal cell carcinoma detected at their institution during 1974-1977 and 1982-1985, with particular emphasis on renal tumors 3.0 cm or smaller. Only 5.3% (four of 75) of renal cell carcinomas found during 1974-1977 but 25.4% (31 of 122) found during 1982-1985 were 3.0 cm or smaller, an increase of almost five times. Of the small tumors in the 1982-1985 group 96.7% (30 of 31) were incidentally discovered, and 77.4% (24 of 31) were initially detected with computed tomography (CT) or ultrasound (US). In the later series 48.4% (15 of 31) of the small renal tumors were treated with partial nephrectomy. Follow-up shows no recurrences. Many more small renal tumors are being detected because of the use of CT and US. This will undoubtedly increase the cure rate of renal cell carcinoma because these tumors are being detected when they are small and do not cause symptoms. Partial nephrectomy will increasingly be used in the management of these small tumors.

Incidental and symptomatic renal tumors: impact on patient survival

“…25,33 Hematuria was the main complaint in the symptomatic cases, in 47% of the cases in this study, and only one patient showed the classical triad (hematuria, back pain and palpable mass) that in the past was seen in 10% of cases 5 and is now only rarely seen. 30 In the last few years there has been an increase in the detection of incidental tumors, 18 directly related to the use of imaging exams, especially ultrasonography and CT scans. 18,34,35 The "internist's tumor" 36 can thus be renamed the "radiologist's tumor", 30 because of the identification of RCC at its early stages, thereby increasing the apparent disease prevalence.…”

“…30 In the last few years there has been an increase in the detection of incidental tumors, 18 directly related to the use of imaging exams, especially ultrasonography and CT scans. 18,34,35 The "internist's tumor" 36 can thus be renamed the "radiologist's tumor", 30 because of the identification of RCC at its early stages, thereby increasing the apparent disease prevalence. 37 These tumors are frequently small and found in routine examinations and evaluations of other diseases, 38,39,40 with greater incidence among younger males and females with a useful working life.…”

“…This has allowed small lesions with favorable prognosis and low incidence of metastasis to be discovered. 8,18,19 Nonetheless, there are no indications of methods for predicting the behavior of small tumors discovered incidentally. 20 Many authors question the factors that might influence the behavior of such neoplasia, believing that incidental tumors may display biological behavior that differs from that of symptomatic tumors.…”

Recent Strategies for the Management of Renal Angiomyolipoma: A Review of Diagnostic and Therapeutic Approaches

“…Along with the growing use of diagnostic imaging tests by ultrasound and CT, more renal AMLs can be detected at random (16). Another characteristic feature of AMLs is abundant fat tissue (17), easily detected by CT or MR images (18).…”

Transition from renal cyst to a renal carcinoma detected by ultrasonography

“…2). An angiogram revealed a single right renal artery and a mildly hypervascular the 1980s [3]. The natural history of malignant cyst transformations is unknown.…”