Retrograde venous invasion in renal cell carcinoma: a complication of sinus vein and main renal vein invasion

Bonsib, Stephen M.; Bhalodia, Ami

doi:10.1038/modpathol.2011.124

Cited by 22 publications

(13 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 18 - 22 According to Bonsib and Bhalodia, unrecognized retrograde vein invasion may have partially contributed to the reportedly worse prognosis associated with larger renal tumors, whose size may have been inflated with confluent nodules of intravenous cancer. 23 Correct renal tumor measurement remains essential for accurate prognostication.…”

Section: Discussionmentioning

confidence: 99%

Correcting the Shrinkage Effects of Formalin Fixation and Tissue Processing for Renal Tumors: toward Standardization of Pathological Reporting of Tumor Size

Tran¹,

Sundaram²,

Bahler³

et al. 2015

J. Cancer

107

View full text Add to dashboard Cite

Given the importance of correctly staging renal cell carcinomas, specific guidelines should be in place for tumor size measurement. While a standard means of renal tumor measurement has not been established, intuitively, tumor size should be based on fresh measurements. We sought to assess the accuracy of postfixation and microscopic measurements of renal tumor size, as compared to fresh measurements and radiographic size. Thirty-four nephrectomy cases performed by a single surgeon were prospectively measured at different time points. The study cases included 23 clear cell renal cell carcinomas, 6 papillary renal cell carcinomas, and 5 other renal tumors. Radiologic tumors were 12.1% larger in diameter than fresh tumors (P<0.01). Furthermore, fresh specimens were 4.6% larger than formalin-fixed specimens (P<0.01), and postfixation measurements were 7.1% greater than microscopic measurements (P<0.01). The overall mean percentage of shrinkage between fresh and histological specimens was 11.4% (P<0.01). Histological processing would cause a tumor stage shift from pT1b to pT1a for two tumors in this study. The shrinkage effects of formalin fixation and histological processing may result in understaging of renal cell carcinomas. The shrinkage factor should be considered when reporting tumor size.

show abstract

Section: Discussionmentioning

confidence: 99%

Correcting the Shrinkage Effects of Formalin Fixation and Tissue Processing for Renal Tumors: toward Standardization of Pathological Reporting of Tumor Size

Tran¹,

Sundaram²,

Bahler³

et al. 2015

J. Cancer

107

View full text Add to dashboard Cite

show abstract

“…The studies by Bonsib et al . have often included dissection by the authors themselves, or specialised handling techniques, such as intravenous dissection with formalin infusion into the venous system . However, we have found that a high rate of renal sinus or venous invasion can be detected even with multiple dissectors, including pathologists, pathologist assistants, and pathology residents.…”

Section: Pt3 Subclassificationmentioning

confidence: 99%

Section: Pt3 Subclassificationmentioning

confidence: 99%

“…This can then result in multiple ‘satellite’ tumour nodules (Figure ), either adjacent to the main mass or distant from it, which can mimic tumour multifocality or become confluent with the original tumour, blurring the distinction of where the primary tumour ends and the vascular invasion begins. The recommendations of Bonsib and Bhalodia are to exclude the intravascular component from the tumour measurement, because, for example, it would be unreasonable to include the ‘tumour thrombus’ in the measurement for a cancer that extends to the level of the heart. However, in some cases, drawing the border of the primary tumour can be difficult (Figure B,C).…”

Section: Pt3 Subclassificationmentioning

confidence: 99%

“…Occasionally, RCCs can also spread backwards within vein branches, a phenomenon that appears to be exclusively associated with occlusion of the main renal vein by tumour, and that is found in approximately 5-8% of RCCs. 34,35 This can then result in multiple 'satellite' tumour nodules (Figure 8), either adjacent to the main mass or distant from it, which can mimic tumour multifocality or become confluent with the original tumour, blurring the distinction of where the primary tumour ends and the vascular invasion begins. The recommendations of Bonsib and Bhalodia 35 are to exclude the intravascular component from the tumour measurement, because, for example, it would be unreasonable to include the 'tumour thrombus' in the measurement for a cancer that extends to the level of the heart.…”

Section: R E T R O G R a D E V E N O U S I N V A S I O Nmentioning

confidence: 99%

See 2 more Smart Citations

Renal cell carcinoma staging: pitfalls, challenges, and updates

2018

View full text Add to dashboard Cite

Renal cell carcinoma (RCC) is unusual among cancers in that it often grows as a spherical, well‐circumscribed mass. Increasing tumour size influences the pathological pT stage category within pT1 and pT2, with cutoffs of 40, 70 and 100 mm; however, with increasing size also comes a sharp increase in the likelihood of renal sinus or renal vein tributary invasion, such that clear cell RCC rarely reaches 70 mm without invading one of these. To clarify some previous challenges in assigning tumour stage, the American Joint Committee on Cancer 2016 tumor–node–metastasis classification has removed the requirements than vein invasion be recognised grossly and that vein walls contain muscle for the diagnosis of vein invasion. Renal pelvis invasion has also been added as an additional route to pT3a. Multinodularity or finger‐like extensions from a renal mass should be viewed with great suspicion for the possibility of vein or renal sinus invasion, and, as tumour size increases to over 40–50 mm, thorough sampling of the renal sinus interface should always be undertaken. With increasing interest in adjuvant therapy in renal cancer, the pathologist's role in RCC staging will continue to be an important prognostic parameter and a tool for selection of patients for enrolment in clinical trials.

show abstract

Tumor Staging for Renal Pathology

Bonsib

2015

Genitourinary Pathology

View full text Add to dashboard Cite

Retrograde venous invasion in renal cell carcinoma: a complication of sinus vein and main renal vein invasion

Cited by 22 publications

References 15 publications

Correcting the Shrinkage Effects of Formalin Fixation and Tissue Processing for Renal Tumors: toward Standardization of Pathological Reporting of Tumor Size

Correcting the Shrinkage Effects of Formalin Fixation and Tissue Processing for Renal Tumors: toward Standardization of Pathological Reporting of Tumor Size

Renal cell carcinoma staging: pitfalls, challenges, and updates

Tumor Staging for Renal Pathology

Contact Info

Product

Resources

About