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Pathologic findings at the time of nephrectomy for renal mass

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Abstract

Background: Ultrasound (US) and computed tomography (CT) have improved the diagnosis of solid renal masses. Nevertheless, some patients still undergo exploration for a presumptive diagnosis of renal cell carcinoma (RCC) and are found to have other pathology. We report a contemporary series of non-RCC renal masses (both incidental and symptomatic) among nephrectomies performed for suspected RCC.

Materials and Methods: All nephrectomies performed by the Urology Service at the Memorial Sloan-Kettering Cancer Center from July of 1989 through July of 1996 for a parenchymal renal mass were reviewed, and patients without a final diagnosis of RCC were identified. Cases were excluded if RCC was not suspected preoperatively. Presentation, preoperative radiographic evaluation, type of operation, and pathologic features were assessed.

Results: Of the 636 nephrectomies performed, 108 patients (16.9%) had a diagnosis other than RCC.

Conclusions: Of patients undergoing nephrectomy for renal masses, 16.9% have other pathologic diagnoses. Sixty-six percent of these non-RCC masses are discovered incidentally, and the majority are treated with radical nephrectomy. Preoperative radiographic evaluation reflects both clinical presentation, with IVP used to evaluate symptomatic tumors, and diagnostic uncertainty, with multiple modalities used to evaluate cystic lesions. This information has important implications for preoperative counseling and surgical planning.

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Author notes

  1. Christopher Morash MD

    Present address: the Division of Urology, Ottawa Civic Hospital, Ottawa, Ontario, Canada

  2. Phillip Brenner MD

    Present address: the Department of Urology, St. Vincent's Clinic, Darlinghurst, Sydney, Australia

  3. Steven Campbell MD

    Present address: the Northwestern University Department of Urology, Chicago, Illinois, USA

Authors and Affiliations

  1. From the Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    David A. Silver MD,  Christopher Morash MD,  Phillip Brenner MD,  Steven Campbell MD &  Paul Russo MD (FACS)

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  1. David A. Silver MD
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  2. Christopher Morash MD
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  4. Steven Campbell MD
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  5. Paul Russo MD
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Silver, D.A., Morash, C., Brenner, P. et al. Pathologic findings at the time of nephrectomy for renal mass. Annals of Surgical Oncology 4, 570–574 (1997). https://doi.org/10.1007/BF02305538

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  • DOI: https://doi.org/10.1007/BF02305538

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