Tumor Size Does Not Predict Risk of Metastatic Disease or Prognosis of Small Renal Cell Carcinomas

Klatte, Tobias; Patard, Jean‐Jacques; Martino, Michela de; Bensalah, Karim; Verhoest, G.; Taille, Alexandre de la; Abbou, Clément-Claude; Allhoff, E. P.; Carrieri, Giuseppe; Riggs, Stephen B.; Kabbinavar, Fairooz; Belldegrun, Arie S.; Pantuck, Allan J.

doi:10.1016/j.juro.2008.01.018

“…19 However, a few contemporary series have reported an incidence of benign disease similar to ours. 7,20 In a study by Klatte and colleagues, which included 1208 patients with renal masses ≤4 cm, 12% had benign disease. 20 Fujii and colleagues found that 11% of renal masses were benign in patients treated with partial nephrectomy for presumed RCC.…”

Section: Discussionmentioning

confidence: 99%

Can tumour location predict degree of malignancy in small renal masses?

Jewett

¹

2013

CUAJ

1

0

1

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Objective: To investigate the association between tumour location and the proportion of benign disease in renal masses presumed to be renal cell carcinoma (RCC) preoperatively. Methods: This Institutional Review Board approved study includes 196 patients who underwent surgical treatment for renal masses <5 cm at our institution by a single surgeon between January 2002 and June 2009. Based on preoperative imaging, each mass was designated as central (touching or encroaching upon the renal collecting system and/or renal sinus) or peripheral. The association between tumour location and benign pathology was determined using univariate and multiple logistic regression, including tumour size and patient sex in the model. Results: The proportion of histologically confirmed benign disease in this series was 11.2%. The proportion of benign disease by location was 5.9% and 19.5% for central and peripheral masses, respectively. The effect of location was found to have a significant prognostic value (p = 0.0273) with an adjusted odds ratio of 3.51 (95% CI = 1.38-19.62) for the odds of a benign diagnosis in peripheral compared to central tumours. Tumour size and patient sex were not significant predictors of benign pathology (p = 0.483 and 0.191, respectively). Conclusions: Peripherally located renal masses are more likely to be benign than centrally located renal masses. This information may be used when selecting strategies for the management of renal masses presumed to be RCC.

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“…Approximately 60% of kidney cancer cases are diagnosed incidentally, as a direct result of the more extensive use of diagnostic imaging in patients not suspected for renal cancer (11,12).…”

Section: Discussionmentioning

confidence: 99%

Severe blood loss anaemia and recurrent intussusceptions as first presentation of bowel metastatic renal cell carcinoma: A case report and review of the literature

Trojaniello

¹

,

Vitale²,

Trojaniello

³

et al. 2017

Molecular and Clinical Oncology

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Abstract. Renal cell carcinoma (RCC) may metastasize to almost any organ, but bowel metastases are highly unusual. A 75-year-old man presented with symptoms and signs of severe anaemia due to bowel bleeding and abdominal pain due to recurrent bowel intussusception. The patient underwent surgery and was identified to have intraluminal metastases from metastatic RCC. To the best of our knowledge, few cases of metastases from RCC manifesting as synchronous intraluminal polypoid tumours have been described in the literature. The present report focused on the importance of two aspects that must be considered: The role of accurate diagnosis and of surgery treating intestinal metastases that may lead to symptom control and prolonged survival. IntroductionRenal cell carcinoma (RCC) is a common malignancy, of which there were ~12,600 cases in 2015 in Italy (1). It represents 3% of all adult malignancies in this region, and is the third most frequent urologic malignancy after prostate and bladder cancer (2). RCC accounts for 90% of kidney cancer cases, and ~80% of these are clear cell carcinomas (3,4). The majority of cases of renal cancer are asymptomatic and are diagnosed incidentally, due to more extensive use of diagnostic imaging, whereas the classic triad of haematuria, flank pain and palpable abdominal mass are rarely the first symptoms of presentation, occurring in 4-17% of cases (5,6).On occasion, the symptoms occurring due to the presence of intestinal metastasis may be the first presentation of renal cancer (7,8). These symptoms usually include nausea, abdominal pain, intussusception, weight loss, melena, bowel perforation, and primarily, gastrointestinal bleeding caused by the infiltration of intestinal vessels (9).The current study presents the case of a 75-year old male in which severe anaemia due to bowel bleeding and abdominal pain from recurrent bowel intussusceptions were the first presentations of metastatic renal cell carcinoma. A review of the cases of bowel metastasis from renal cell carcinoma described in the literature from 2006 to the present was also conducted (Table I). Written informed consent was obtained from the patient for the publication of this case report and accompanying images. Case presentationIn February 2014, a 75-year old male presented to San Paolo Hospital (Naples Italy) emergency department with symptoms and signs of severe anaemia: Tachycardia, pallor, fatigue and hypotension. The patient's medical history was relevant for chronic gastritis, prostate cancer, diabetes mellitus and Parkinson's disease, recurrent abdominal pain and constipation. Laboratory tests revealed severe anaemia (haemoglobin level, 5.6 g/dl, normal range 14-18 g/dl) that required a transfusion of packed red blood cells. At rectal examination, tarry stools compatible with melena were evident and an esophagogastroduodenoscopy was performed, but was negative for bleeding lesions. Abdominal ultrasound revealed the presence of a lesion of 35 mm in the lower pole of the left kidney suspicious for a neoplastic les...

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“…7,20 In a study by Klatte and colleagues, which included 1208 patients with renal masses ≤4 cm, 12% had benign disease. 20 Fujii and colleagues found that 11% of renal masses were benign in patients treated with partial nephrectomy for presumed RCC. 7 They suggest that this may be due to a smaller proportion of oncocytomas in Japanese patients (2.8%) compared with the 5% reported in western countries.…”

Section: Discussionmentioning

confidence: 99%

Tumour location as a predictor of benign disease in the management of renal masses

Mason¹,

Abdolell²,

Rendon³

2013

CUAJ

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Objective: To investigate the association between tumour location and the proportion of benign disease in renal masses presumed to be renal cell carcinoma (RCC) preoperatively. Methods: This Institutional Review Board approved study includes 196 patients who underwent surgical treatment for renal masses <5 cm at our institution by a single surgeon between January 2002 and June 2009. Based on preoperative imaging, each mass was designated as central (touching or encroaching upon the renal collecting system and/or renal sinus) or peripheral. The association between tumour location and benign pathology was determined using univariate and multiple logistic regression, including tumour size and patient sex in the model. Results: The proportion of histologically confirmed benign disease in this series was 11.2%. The proportion of benign disease by location was 5.9% and 19.5% for central and peripheral masses, respectively. The effect of location was found to have a significant prognostic value (p = 0.0273) with an adjusted odds ratio of 3.51 (95% CI = 1.38-19.62) for the odds of a benign diagnosis in peripheral compared to central tumours. Tumour size and patient sex were not significant predictors of benign pathology (p = 0.483 and 0.191, respectively). Conclusions: Peripherally located renal masses are more likely to be benign than centrally located renal masses. This information may be used when selecting strategies for the management of renal masses presumed to be RCC.

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Tumor Size Does Not Predict Risk of Metastatic Disease or Prognosis of Small Renal Cell Carcinomas

Cited by 142 publications

References 20 publications

Can tumour location predict degree of malignancy in small renal masses?

Can tumour location predict degree of malignancy in small renal masses?

Severe blood loss anaemia and recurrent intussusceptions as first presentation of bowel metastatic renal cell carcinoma: A case report and review of the literature

Tumour location as a predictor of benign disease in the management of renal masses

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