Renal Tumors in Adult Saudi Patients: A Review of 43 Cases
|
|
- Asher Norman
- 5 years ago
- Views:
Transcription
1 Riyadh F. Talic, FRCS(Ed); Salah R. El Faqih, FRCS From the Division of Urology, Department of Surgery, King Khalid University Hospital, King Saud University, Riyadh. Address reprint requests and correspondence to Dr. Talic: Assistant Professor of Urology, Division of Urology, Department of Surgery, King Khalid University Hospital, P.O. Box 7805, Riyadh 11472, Saudi Arabia. Accepted for publication 9 April Received 23 December Seventy-nine patients with renal tumors were seen at King Khalid University Hospital (KKUH) over a 10-year period from 1985 through November In a retrospective study, we analyzed the records of 43 Saudi patients from all over the Kingdom; they represented 54% of all patients encountered. Fourteen percent of the patients had benign renal tumors in the form of angiomyolipoma and oncocytoma. Eighty-six percent of the patients had malignant renal tumors. The largest subset of 33 patients (76.7%) had renal cell carcinoma (RCC). The mean age of this group was 50.9, with a male-to-female ratio of 1.3:1. The duration of symptoms varied widely from a few months to a few years and the most common presenting symptom was loin pain. Only four patients were smokers and one patient had Von Hippel Lindau syndrome; no other risk factors could be identified in this group. This study shows a large percentage of angiomyolipoma among the tumors encountered. It also shows a high percentage of Saudi female patients in the RCC group; otherwise, the pattern and clinicopathological features resemble those presented in the international literature. Ann Saudi Med 1996;16(5): RF. Talic, SR. El Faqih, Renal Tumors in Adult Saudi Patients: A Review of 43 Cases. 1996; 16(5): Renal tumors include both benign and malignant new growths of the kidney. The majority are malignant, and renal cell carcinoma (RCC) is the most common histological type. 1 The incidence of renal tumors, and in particular of RCC, is unknown in Saudi Arabia. Epidemiological studies show that there is a global trend of a rising incidence of renal cancer, with little definite information on the underlying etiology. 2 The literature on renal tumors in adult Saudi patients is very scarce. We designed this retrospective study to look at the pattern, clinicopathologic features and possible underlying etiologic factors of various renal tumors in adult Saudi patients who presented to the Urology Unit at KKUH. Patients and Methods We reviewed the records of 79 patients with renal tumors who presented from 1986 through November 1995; 36 patients were non-saudi and were excluded from the final analysis because of their diverse ethnic origin. The charts of the remaining patients were analyzed for age, sex, mode of presentation and duration of symptoms. All patients underwent standard laboratory investigations, including complete blood count, serum electrolytes and creatinine, liver function tests and urinalysis. Radiological tests for diagnosis and staging included chest roentgenography, intravenous pyelogram or ultrasound of the kidneys, abdominal computerized tomography and bone scans. Selective renal angiography was carried out as indicated. Associated paraneoplastic syndromes, systemic illnesses and possible etiological factors were noted. The tumor laterality, polarity, size and histological typing were also recorded. Tumor staging of RCC was classified according to Flock's and Kadesky (1958). 1 Stage I: tumor confined to the kidney; Stage II: tumor invading perirenal fat but confined by Gerota's fascia; Stage III (a): tumor in renal vein or inferior vena cava; Stage III (b): tumor in lymph nodes; and Stage IV: involvement of adjacent organs or distant metastasis. Results A total of 43 Saudi patients presenting from various regions of the Kingdom were included in the study. Six patients had 10 benign renal tumors. Table 1 shows the patient characteristics of this group. Four patients presented with symptoms and signs similar to those with renal cancer. Patients 4 and 6 were diagnosed incidentally by ultrasound during investigation of postpartum bleeding and an attack of calculus cholecystitis, respectively. Patient No. 5 had a past history of epilepsy, and was noted to have features of tuberous sclerosis complex after she was diagnosed with bilateral angiomyolipoma; cerebral subependymal calcifications were noted on her computerized tomography scan of the brain. Preoperative diagnosis of angiomyolipoma was also achieved in patient No. 4, ultrasound and computerized tomography showing characteristic findings of angiomyolipoma in both kidneys. Left
2 nephrectomy was carried out on both these patients to remove bleeding tumors. The right kidney, with multiple small angiomyolipomas, is being followed up. The other four patients underwent radical nephrectomy for suspicion of malignancy. The benign nature of their tumors was confirmed on histological examination of the surgically excised kidneys. They remain well on follow-up; one patient (#3 in Table 1) developed a contralateral tumor with radiological features consistent with angiomyolipoma and is being followed up expectantly. Thirty-seven patients had malignant tumors. Two patients in this group had transitional cell carcinoma of the renal pelvis; both were males, 52 and 53 years old, and both presented with hematuria. Both patients underwent nephroureterectomy and were found to have G2PT2 and G2PT3 disease. Renal squamous cell carcinoma was encountered in two patients. A 50-year-old female and a 63-year-old male both presented with loin pain and on investigation were noted to have nonfunctioning kidneys. Intravenous pyelogram demonstrated a staghorn calculus in one patient and chronic pyelonephritic changes in the other, but no suggestion of malignancy. Simple nephrectomy was carried out and histological examination confirmed Stage I and II disease, respectively. The largest group (33 patients) had renal cell carcinoma; they included 19 male and 14 female patients (M:F ratio 1.3:1). Their ages ranged between 17-85, with a mean age of 50.9 ± The mean age for the male patients was 52.9 ± 18.9 (range 17-85), while the mean age for the female patients was 48.8 ± 6.3 (range 40-65). The duration of symptoms varied widely from a few months to a few years. Table 2 shows the various presentations of RCC. Only two patients (5%) presented with the so-called "classical triad," consisting of loin pain, hematuria and renal mass. Eleven tumors in 10 patients (30%) were diagnosed incidentally by ultrasound; the investigation was carried out for upper GI symptoms in six patients, ovarian cyst in one, lower urinary tract symptoms in one, as part of a routine health checkup in one and for screening purposes in one patient with Von Hippel Lindau syndrome initially presenting with blurred vision. This patient, on further investigation, was noted to have cerebellar hemangioblastoma and epididymal papillary cystadenoma. Seven of the incidentally diagnosed RCC were Stage I (64%), two were Stage II (18%) and two were Stage IV (18%). Nineteen patients with RCC had right-sided tumors, 13 had left-sided and one patient had bilateral synchronous RCC. These tumors were occupying the lower pole in 12 patients, the upper pole in 11 patient, and the middle pole in four patients. It was not specified in the rest, mainly due to the large size of the tumor extending beyond one pole. Table 3 show the various presentations by stage of renal cell carcinoma and average size of the tumors. Both patients with Stage III (a) had a tumor thrombus extending into the abdominal part of their inferior vena cava. Five of the patients with Stage IV had systemic metastasis; two patients had metastasis to the liver and the lung, one patient had brain metastasis, one patient had widespread bony deposits, and one patient had metastasis into the contralateral adrenal gland; the other two patients with Stage IV had involvement of a retroperitoneal cyst in one and infiltration into the posterior abdominal wall in the other. Table 1. Patients with benign renal tumors. Patient Age Sex Tumor 1 60 F Left angiomyolipoma 2 66 F Left simultaneous oncocytoma and angiomyolipoma 3 29 F Bilateral asynchronous angiomyolipoma 4 25 F Bilateral synchronous angiomyolipoma 5 29 F Bilateral synchronous angiomyolipoma 6 68 M Right angiomyolipoma
3 Table 2. Clinical features at presentation of RCC. Symptom (%) Loin pain 48 Hematuria 33 Mass 15 Weight loss 18 Fever 12 Malaise 9 Varicocele 3 Raised ESR 45 Anemia 6 Hypertension 12 Polycythemia 3 Table 3. RCC by stage and size. Stage No. of patients (%) Average size (cm) and range I 19 (58%) 7.9 (2.5-16) II 5 (15%) 8.5 (5.0-16) III 2 (6%) 9.7 (7.7-12) IV 7 (21%) 6.0 (4.2-11) Table 4. Presentation by stage of RCC. Source Stage I Stage II Stage III Stage IV Skinner et al % 7% 35% 25% Robson et al % 17% 31% 14% Best 15 46% 5.5% 19.5% 29% Present study 58% 15% 6% 21% All patients with Stages I-III of RCC were subjected to surgery. Radical nephrectomy was the standard procedure; the patient with bilateral RCC had bilateral partial nephrectomy. The patient with solitary metastasis into the adrenal gland had radical nephrectomy and contralateral adrenalectomy; the other patient with involvement of the retroperitoneal cysts had all the tumor mass successfully removed and the patient in Stage IV with infiltration of the posterior abdominal wall underwent exploration, but the tumor was deemed inoperable. Among tumors excised, 15 (44%) were clear cell, six (18%) granular cell, seven (20%) mixed cell type and the rest were undetermined. Only four patients gave a history of smoking; one patient had Von Hippel Lindau syndrome and no patients with chronic renal failure and acquired cystic kidney disease were encountered. Other dietary and environmental risk factors could not be studied from the retrospective data available. Discussion Renal tumors and, in particular, renal cell carcinoma are uncommon, accounting for 3% of adulthood malignancies in the West with variable international variation, 1,3 the incidence of RCC being high in Northern Europe and North America and lower in Asian countries. 3 The incidence in Saudi Arabia is not known; the various studies that looked at cancer pattern in Saudi Arabia either fail to mention renal tumors as an entity, or cite wide variations with relative frequency ranging between l-2.75%. 4-7 These differences may be due to variations in the incidence of the disease in the various provinces of Saudi Arabia; but may also be a reflection of the referral pattern of patients in the country. Among the various recognized benign renal tumors, we encountered only renal angiomyolipoma and oncocytoma. Renal angiomyolipoma accounted for 14% of the cases in our group, which is much higher than that reported in the literature of 1% of all surgically excised tumors. 8 Renal angiomyolipoma is known to affect females predominantly; 9 this is consistent with our findings where all patients but one were females. Fifty percent of all renal angiomyolipoma occur in tuberous sclerosis patients and up to 80% of patients with tuberous sclerosis exhibit
4 angiomyolipoma. 9,10 Only one of our patients had the stigmas of tuberous sclerosis complex. Renal angiomyolipoma in association with renal cell carcinoma has been described previously. 10,11 We did not come across such patients in our group, but one patient (No. 2 in Table 1) had unilateral simultaneous angiomyolipoma and oncocytoma, an association that has been described only once in the international literature. 12 Renal cell carcinoma is the most common solid renal tumor in adults, accounting for 80% of all renal tumors. 1,3 This is consistent with our findings. Half of our renal urothelial tumors were squamous cell carcinoma, which usually account for less than 15% of such tumors. 1 It is difficult to make any firm conclusions on this small number of patients, but this might be due to the high prevalence of renal calculus and chronic renal inflammatory diseases in our community. 1,3 The mean age and clinical presentation for our patients with renal cell carcinoma were consistent with that reported in the literature. 1,13-15 Loin pain or hematuria are the most common presenting symptoms in most series. 1,13,15,16 The most common presenting symptom in our patients was loin pain. Hematopoietic disturbances and endocrinopathies such as polycythemia, anemia and raised ESR have been reported in association with renal cell carcinoma. 1 We did encounter such patients (Table 2), but less frequently than expected. Presentation with paraneoplastic syndromes such as elevated parathyroid-like hormone manifesting as hypercalcemia or hepatic dysfunction is described with variable incidence. 1 No patient in our group presented as such. Renal cell carcinoma affect males predominantly. A male-to-female ratio of 2-3:1 is reported in many series Jamal et al. reported on a group of 30 patients with renal neoplasia; among those, there were 21 Saudi patients with a M:F ratio of 4:1. 16 This was not our observation, where the ratio of 1.3:1 suggests a higher occurrence in Saudi females. This observation is difficult to explain, but if confirmed in future reports, would indicate the necessity to investigate Saudi females closely for peculiar risk factors. Presentation by stage is compared to other series in Table 4. Seventy-three percent of patients with RCC in our group presented in Stage I and II and 21% presented in Stage IV. These results are compatible with other reports and suggest that there is no delay in the presentation or diagnosis of renal cancer in our patients similar to that seen with other urological cancers in Saudi Arabia ,17 Only 6% of the patients presented in Stage III, a much smaller but variable percentage in comparison to other studies. The incidence of patients with Stage III disease varies greatly in different reports and usually follows the referral pattern to tertiary centers that deal with these patients Renal tumors are being diagnosed as an incidental finding with increasing frequency in recent years. In accordance with other reports that show 20% to 30% prevalence of incidental RCC, 30% of our patients were diagnosed incidentally. All our patients were diagnosed with ultrasound examination, which is the most common imaging modality in detecting incidental renal tumors. 19 Recent advances, wider application of imaging diagnostic studies, and availability of medical services in Saudi Arabia may account for this prevalence in our group. The etiology of renal tumors is poorly understood. There are no definite risk factors, with the possible exception of tobacco smoking and acquired cystic disease of the kidney developing in patients with chronic renal failure on chronic dialysis. 2,3 The relation of all other environmental, dietary, and familial factors are not clear. 2 For this reason, it is difficult to establish, in a group of patients like ours, whether there are any particular risk factors peculiar to the Saudi population. We conclude that we encountered a high percentage of renal angiomyolipoma in our group of patients with renal tumors. An interesting finding was the lower incidence of tuberous sclerosis in our patients with renal angiomyolipoma. We also encountered a high percentage of female patients. Otherwise, renal tumors, in particular RCC, in Saudi patients resemble other groups in the literature with regard to their clinicopathological features. It is hoped that established tumor registries and future epidemiological studies will shed more light on the true incidence, patterns and possible risk factors that are relevant to our patients. References 1. dekernion JB. Renal tumors. Campbell's Urology, 5th edition, Philadelphia: W. B. Saunders, Katz DL, Zheng T, Holford TR, Flannery J. Time trends in the incidence of renal carcinoma: analysis of Connecticut tumor registry data, J Cancer 1994;58: Dayal H, Kinman J. Epidemiology of kidney cancer. Sem Onco 1983;10: Mahboubi E. Epidemiology of cancer in Saudi Arabia, Ann Saudi Med 1987;7: Khan A, Hussain NK, Al-Saigh A, Malatani T, Sheikha AA. Pattern of cancer at Asir Hospital, Abha, Saudi Arabia. Ann Saudi Med 1991;11: Ajarim DS. Cancer at King Khalid University Hospital, Riyadh. Ann Saudi Med 1992;12:76-82.
5 7. Al-Saigh AH, Allam MM, Khan KA, Al Hawasi ZM. Pattern of cancer in Madina Al-Munawara region. Ann Saudi Med 1995;15: Sant GR, Ayers DK, Bankoff MS, Mitcheson HD, Ucci AA. Fine needle aspiration biopsy in the diagnosis of renal angiomyolipoma. J Urol 1990;143: Malone MJ, Johnson PR, Jumper BM, Howard PJ, Hopkins TB, Libertino JA. Renal angiomyolipoma: 6 case reports and literature review. J Urol 1986;135: Graves N, Barnes W. Renal cell carcinoma and angiomyolipoma in tuberous sclerosis: case report. J Urol 1986;135: Takeyama M, Arima M, Sagawa S, Sonoda T. Preoperative diagnosis of coincident renal cell carcinoma and renal angiomyolipoma in nontuberous sclerosis. J Urol 1982;128: Waters DJ, Holt SA, Andres DF. Unilateral simultaneous angiomyolipoma and oncocytoma. J Urol 1986;135: Skinner DG. Colvin RB, Vermillion CD, Pfister RC, Leadbetter WF. Diagnosis and management of renal cell carcinoma. Cancer 1971;28: Robson CJ, Churchill BM, Anderson W. The results of radical nephrectomy for renal cell carcinoma. J Urol 1969;101: Best BG. Renal carcinoma: a 10-year review Br J Urol 1987;60: Jamal A, Abomelha MS, Etaibi K, Kourah M. Renal neoplasia five years' experience at Riyadh Armed Forces Hospital. Saudi Med J 1989;10: Kattan S, Yousef A, Onuora V, Patil M, Al-Jasser A, Al-Ariyan R. The clinicopathological features of bladder carcinoma among Saudis in Riyadh Central Hospital. Ann Saudi Med 1994;14: Konnak JW, Grossman HB. Renal cell carcinoma as an incidental finding. J Urol 1985;134: Aso Y, Homma Y. A survey on incidental renal cell carcinoma in Japan. J Urol 1992;147: Thompson IM, Peek M. Improvement in survival of patients with renal cell carcinoma the role of the serendipitouslydetected tumor. J Urol 1988;140:
Sex: 女 Age: 51 Occupation: 無 Admission date:92/07/22
Sex: 女 Age: 51 Occupation: 無 Admission date:92/07/22 Chief complaint Unknown fever for one month Hand tremor and left huge renal tumor was noted Present illness Suffered from fever for one month, hand
More informationRenal Parenchymal Neoplasms
Renal Parenchymal Neoplasms د. BENIGN TUMORS : Benign renal tumors include adenoma, oncocytoma, angiomyolipoma, leiomyoma, lipoma, hemangioma, and juxtaglomerular tumors. Renal Adenomas : The adenoma is
More informationGUIDELINES ON RENAL CELL CANCER
20 G. Mickisch (chairman), J. Carballido, S. Hellsten, H. Schulze, H. Mensink Eur Urol 2001;40(3):252-255 Introduction is characterised by a constant rise in incidence over the last 50 years, with a predominance
More informationSolitary Contralateral Adrenal Metastases after Nephrectomy for Renal Cell Carcinoma
Original Report ISSN 1537-744X; DOI 10.1100/tsw.2004.39 Solitary Contralateral Adrenal after Nephrectomy for Renal Cell Carcinoma Nikolaos Antoniou, M.D. and Demetrios Karanastasis, M.D. General Hospital
More informationRenal tumors of adults
Renal tumors of adults Urinary Tract Tumors 2%-3% of all cancers in adults. The most common malignant tumor of the kidney is renal cell carcinoma. Tumors of the lower urinary tract are twice as common
More informationRENAL CELL CARCINOMA 2 to 3% of All New Visceral Cancers Peak Incidence is 6th Decade M:F = 2:1 Grossly is a Bright Yellow, Necrotic Mass with a Pseud
GENITOURINARY PATHOLOGY Kathleen M. O Toole Toole, M.D. RENAL CELL CARCINOMA 2 to 3% of All New Visceral Cancers Peak Incidence is 6th Decade M:F = 2:1 Grossly is a Bright Yellow, Necrotic Mass with a
More informationTumors of kidney and urinary bladder
Tumors of kidney and urinary bladder Overview of kidney tumors Benign and malignant Of the benign: papillary adenoma -cortical -small (0.5cm) -in 40% of population -clinically insignificant The most common
More information2 to 3% of All New Visceral Cancers Peak Incidence is 6th Decade M:F = 2:1 Grossly is a Bright Yellow, Necrotic Mass with a Pseudocapsule
GENITOURINARY PATHOLOGY Kathleen M. O Toole, M.D. Renal Cell Carcinoma 2 to 3% of All New Visceral Cancers Peak Incidence is 6th Decade M:F = 2:1 Grossly is a Bright Yellow Necrotic Mass Grossly is a Bright
More informationMale genital tract tumors. SiCA. Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital.
Male genital tract tumors Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital. adenocarcinoma Prostate Cancer most common male cancer in western countries more detected in
More informationCase Report Renal Cell Carcinoma Metastatic to Thyroid Gland, Presenting Like Anaplastic Carcinoma of Thyroid
Case Reports in Urology Volume 2013, Article ID 651081, 4 pages http://dx.doi.org/10.1155/2013/651081 Case Report Renal Cell Carcinoma Metastatic to Thyroid Gland, Presenting Like Anaplastic Carcinoma
More informationBilateral Renal Angiomyolipomas with Invasion of the Renal Vein: A Case Report
Case Study TheScientificWorldJOURNAL (2008) 8, 145 148 TSW Urology ISSN 1537-744X; DOI 10.1100/tsw.2008.29 Bilateral Renal Angiomyolipomas with Invasion of the Renal Vein: A Case Report C. Blick, N. Ravindranath,
More informationGUIDELINES ON RENAL CELL CARCINOMA
GUIDELINES ON RENAL CELL CARCINOMA B. Ljungberg (chairman), D.C. Hanbury, M.A. Kuczyk, A.S. Merseburger, P.F.A. Mulders, J-J. Patard, I.C. Sinescu Introduction This EAU guideline was prepared to help urologists
More informationUrological Tumours 1 Kidney tumours 2 Bladder tumours
Urological Tumours 1 Kidney tumours 2 Bladder tumours Tim Bracey SpR Histopathology Derriford Hospital Kidney tumours What are we going to talk about?! Anatomy of urinary tract! Types of kidney tumours!
More informationFive Views of Transitional Cell Carcinoma: One Man s Journey
September 2006 Five Views of Transitional Cell Carcinoma: One Man s Journey Amsalu Dabela, Harvard Medical School III Outline Overview: Renal Anatomy Our Patient s Story Diagnostic Imaging Studies Appearance
More informationGuidelines on Renal Cell
Guidelines on Renal Cell Carcinoma (Text update March 2009) B. Ljungberg (Chairman), D.C. Hanbury, M.A. Kuczyk, A.S. Merseburger, P.F.A. Mulders, J-J. Patard, I.C. Sinescu Introduction Renal cell carcinoma
More informationPediatric Retroperitoneal Masses Radiologic-Pathologic Correlation
Acta Radiológica Portuguesa, Vol.XVIII, nº 70, pág. 61-70, Abr.-Jun., 2006 Pediatric Retroperitoneal Masses Radiologic-Pathologic Correlation Marilyn J. Siegel Mallinckrodt Institute of Radiology, Washington
More informationRenal Cancer. By Jamie Calderwood
Renal Cancer By Jamie Calderwood ("Kidney Cancer")*1 ("What are the different types of kidney mass?")*2 What is it? Renal cancer is more commonly known as kidney cancer. Wilms tumor Another name for kidney
More informationRenal cell carcinoma (RCC)
Renal cell carcinoma (RCC) Introduction The most common solid renal tumor. Accounts for 2 3% of all adult malignancies. It is the 3 rd most common urological tumor in men and the 2 nd in women. It is th
More informationthe urinary system pathology Dr. Fairoz A Eltorgman
the urinary system pathology Dr. Fairoz A Eltorgman Tumors of the renal pelvis & kidney Benign tumors of the renal pelvis: Hemangioma Leiomyoma Malignant tumors: Transitional cell carcinoma Squamous cell
More information1/25/13 Right partial nephrectomy followed by completion right radical nephrectomy.
History and Physical Case Scenario 1 45 year old white male presents with complaints of nausea, weight loss, and back pain. A CT of the chest, abdomen and pelvis was done on 12/8/12 that revealed a 12
More informationInternational Journal of Medical and Health Sciences
International Journal of Medical and Health Sciences Journal Home Page: http://www.ijmhs.net ISSN:2277-4505 Case Report Squamous Cell Carcinoma Of Renal Pelvis- A Rare Case Report S. S. Inamdar* 1, Sainath
More informationKidney Cancer Early Detection, Diagnosis, and Staging
Kidney Cancer Early Detection, Diagnosis, and Staging Detection and Diagnosis Catching cancer early often allows for more treatment options. Some early cancers may have signs and symptoms that can be noticed,
More informationRENAL CELL CARCINOMA METASTASIZING TO PAROTID GLAND ABSTRACT
CASE REPORT RENAL CELL CARCINOMA METASTASIZING TO PAROTID GLAND Mutahir A. Tunio 1, Mushabbab Al Asiri 2, Asim Ali Elbagir Mohammad 3, Khalid Riaz 4 1,4 Department of Radiation Oncology, King Fahad Medical
More information!! 2 to 3% of All New Visceral Cancers.!! Peak Incidence is 6th Decade!! M:F = 2:1
!! Kathleen M. O Toole, M.D.!! 2 to 3% of All New Visceral Cancers!! Peak Incidence is 6th Decade!! M:F = 2:1!! Grossly is a Bright Yellow, Necrotic Mass with a Pseudocapsule 1 !!Conventional RCC! Clear
More informationNAACCR Webinar Series 1
NAACCR 2009 2010 Webinar Series Collecting Cancer Data: Kidney 1 Questions Please use the Q&A panel to submit your questions Send questions to All Panelist 2 Fabulous Prizes 3 NAACCR 2009 2010 Webinar
More informationConcurrent Multilocular Cystic Renal Cell Carcinoma and Leiomyoma in the Same Kidney: Previously Unreported Association
218 Concurrent Multilocular Cystic Renal Cell Carcinoma and Leiomyoma in the Same Kidney: Previously Unreported Association Min Su Cheong a Dong Hun Koo a In-Sung Kim a Kyung Chul Moon b Ja Hyeon Ku a
More informationSurgically Discovered Xanthogranulomatous Pyelonephritis Invading Inferior Vena Cava with Coexisting Renal Cell Carcinoma
Case Study TheScientificWorldJOURNAL (2009) 9, 5 9 TSW Urology ISSN 1537-744X; DOI 10.1100/tsw.2009.6 Surgically Discovered Xanthogranulomatous Pyelonephritis Invading Inferior Vena Cava with Coexisting
More informationVincenzo Ficarra 1,2,3. Associate Editor BJU International
Partial Nephrectomy for RCC Vincenzo Ficarra 1,2,3 1 Director Department of Urology University of Udine, Italy 2 Associate Editor BJU International 3 Scientific Director OLV Robotic Surgery Institute,
More informationRole of MDCT in Radiological evaluation of Renal Masses and its beneficial effects on patient management.
International Journal of advances in health sciences (IJHS) ISSN 2349-7033 Vol2, Issue1, 2015, pp56-63 http://www.ijhsonline.com Research Article Role of MDCT in Radiological evaluation of Renal Masses
More informationBaker Alabbadi MD*, Ali Alasmar MD*, Ayman Alqarallah MD*, Nizar Saaydah MD* ABSTRACT
Renal Cell Carcinoma Clinical Presentation and Histopathological Findings: A Retrospective Analysis of a Jordanian Population at King Hussein Medical Center Baker Alabbadi MD*, Ali Alasmar MD*, Ayman Alqarallah
More informationUroradiology For Medical Students
Uroradiology For Medical Students Lesson 8 Computerized Tomography 2 American Urological Association Objectives In this lesson you will: Gain more experience reading CT images Learn how computer generated
More informationKIDNEY HEALTH. Kidney Masses and Localized Kidney Tumors: A Patient Guide
KIDNEY HEALTH Kidney Masses and Localized Kidney Tumors: A Patient Guide Table of Contents Kidney & Adrenal Health Committee Renal Mass Committee.... 2 Patient Story.... 3 Introduction: I have a kidney
More informationComplex case Presentations
Complex case Presentations Case Presentations April 2016 Lisa M Pickering Case presentations: chromophobe renal carcinoma 60 year old man. ECOG PS 0 No significant comorbodities August 2009: L radical
More informationIndex. Note: Page numbers of article titles are in boldface type.
Magn Reson Imaging Clin N Am 12 (2004) 587 591 Index Note: Page numbers of article titles are in boldface type. A Adenoma(s), adrenal, gadolinium-enhanced MR imaging in, 533 534 hyperfunctioning versus
More informationPartial Nephrectomy Techniques for Renal Preservation: Historical and Modern Approaches
Partial Nephrectomy Techniques for Renal Preservation: Historical and Modern Approaches Cary N Robertson MD FACS Associate Professor Division of Urology Associate Director Urologic Oncology Duke Cancer
More informationThe Incidental Renal Mass in the Primary Care Setting
The Incidental Renal Mass in the Primary Care Setting Adele M. Caruso, MSN, CRNP Adult Nurse Practitioner The Perelman School of Medicine at the University of Pennsylvania Abstract There are approximately
More informationEVALUATION OF THE OUTCOME OF THE MANAGEMENT OF PATIENTS WITH RENAL CELL CARCINOMA
International Invention Journal of Medicine and Medical Sciences (ISSN: 2408-7246) Vol. (9) pp. 99-204, November, 206 Available online http://internationalinventjournals.org/journals/iijmms Copyright 206
More informationRECURRENT ADRENAL DISEASE. Megan Applewhite Endorama 2/19/2015 SR , SC
RECURRENT ADRENAL DISEASE Megan Applewhite Endorama 2/19/2015 SR 2412318, SC 3421561 Category: Adrenal Attendings: Angelos & Grogan PATIENT #1 36yo woman with a hx of Cushing s Syndrome and right adrenalectomy
More informationManchester Cancer. Guidelines for the management of renal cancer
Guidelines for the management of renal cancer Approved by the urology pathway board September 2014 To be reviewed September 2016 Renal Cancer Guidelines 1. Introduction 1.1 Kidney cancer accounts for 3%
More informationRenal Pelvis Squamous Cell Carcinoma and Renal Cell Carcinoma in a Tuberculous Kidney
Case Study TheScientificWorldJOURNAL (2004) 4, 965 968 ISSN 1537-744X; DOI 10.1100/tsw.2004.196 Renal Pelvis Squamous Cell Carcinoma and Renal Cell Carcinoma in a Tuberculous Kidney M. Al-Assiri 1, M.F.
More informationRole of imaging in RCC. Ultrasonography. Solid lesion. Cystic RCC. Solid RCC 31/08/60. From Diagnosis to Treatment: the Radiologist Perspective
Role of imaging in RCC From Diagnosis to Treatment: the Radiologist Perspective Diagnosis Staging Follow up Imaging modalities Limitations and pitfalls Duangkamon Prapruttam, MD Department of Therapeutic
More informationPathologic Characteristics of Solitary Small Renal Masses. Can They Be Predicted by Preoperative Clinical Parameters?
Anatomic Pathology / Pathology of Small Renal Masses Pathologic Characteristics of Solitary Small Renal Masses Can They Be Predicted by Preoperative Clinical Parameters? Tom DeRoche, MD, 1 Esteban Walker,
More informationRENAL CELL CARCINOMA. About Renal cell carcinoma
RENAL CELL CARCINOMA Rcc, Grawitz Tumor A kidney cancer that originates in a part of the very small tubes in the kidney that transport waste molecules from the blood to the urine. Diagnosis Male & Female
More information250 CASES OF CARCINOMA OF URINARY BLADDER A PRELIMINARY REVIEW
250 CASES OF CARCINOMA OF URINARY BLADDER A PRELIMINARY REVIEW Pages with reference to book, From 102 To 105 S. Adeebul Hassan Rizvi, S. Anwar Naqvi ( Department of Urology, Dow Medical College and Civil
More informationKidney, Bladder and Prostate Neoplasia. David Bingham MD
Kidney, Bladder and Prostate Neoplasia David Bingham MD typical malignant cytology of bladder washings 1 benign 2 malignant typical malignant cytology of bladder washings b Bladder tumor Non invasive papillary
More informationUICC TNM 8 th Edition Errata
UICC TNM 8 th Edition Errata ions are in italics Page 28 Oropharynx p16 positive Pathological Stage II,T2 N2 M0 T3 N0,N1 M0 Stage II,T2 N2 M0 T3,T4 N0,N1 M0 Page 61 Oesophagus Adenocarcinoma Pathological
More informationAutosomal Dominant Polycystic Kidney Disease
Case Studies [1] July 01, 2014 By Amar Udare, MBBS [2] Case History: 45-year-old female with vague pain in the abdomen. Case History: A 45-year-old female presented with vague pain in the abdomen. A USG
More informationAuthor(s) Gohji, Kazuo; Gotoh, Akinobu; Kamid. Citation 泌尿器科紀要 (1990), 36(7):
Title Giant renal angiomyolipoma with an pattern: a case report Author(s) Gohji, Kazuo; Gotoh, Akinobu; Kamid Citation 泌尿器科紀要 (1990), 36(7): 837-840 Issue Date 1990-07 URL http://hdl.handle.net/2433/116942
More informationWilms Tumor and Neuroblastoma
Wilms Tumor and Neuroblastoma Wilm s Tumor AKA: Nephroblastoma the most common intra-abdominal cancer in children. peak incidence is 2 to 3 years of age Biology somatic mutations restricted to tumor tissue
More informationRenal Masses in Patients with Known Extrarenal Primary Primary Cancer Primary Primary n Met Mets s RCC Beni L mphoma Lung Breast Others
The Importance of Stuart G. Silverman, MD, FACR Professor of Radiology Harvard ard Medical School Director, Abdominal Imaging and Intervention Brigham and Women s Hospital Boston, MA The Importance of
More informationCase Scenario 1: Thyroid
Case Scenario 1: Thyroid History and Physical Patient is an otherwise healthy 80 year old female with the complaint of a neck mass first noticed two weeks ago. The mass has increased in size and is palpable.
More informationHyperechoic renal masses
Hyperechoic renal masses Jean-Yves Meuwly, MD Department of Diagnostic and Interventional Radiology, University Hospital Lausanne, Switzerland Department of Diagnostic and Interventional Radiology Renal
More informationCLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION
Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 4/30/2011 Radiology Quiz of the Week # 18 Page 1 CLINICAL PRESENTATION AND RADIOLOGY
More informationSeparating and Distorted Nephroliths Signs of Renal Squamous Cell Carcinoma
Chin J Radiol 2003; 28: 203-208 203 Separating and Distorted Nephroliths Signs of Renal Squamous Cell Carcinoma TZE-YU LEE SHEUNG-FAT KO CHUNG-CHENG HUANG YU-FENG CHENG Department of Radiology, Chang Gung
More informationNEPHRECTOMY AUDIT. OCTOBER 1998-SEPTEMBER 2005 Dr. Sanjeev Bandi MBBS., FRCSI., FRACS(Urology) Mater Misericordiae Hospital, Mackay, Qld 4740
NEPHRECTOMY AUDIT OCTOBER 1998-SEPTEMBER 2005 Dr. Sanjeev Bandi MBBS., FRCSI., FRACS(Urology) Mater Misericordiae Hospital, Mackay, Qld 4740 This audit has been performed in conjunction with the data requirements
More informationCase Based Learning Program
Case Based Learning Program The Department of Urology Glickman Urological & Kidney Institute Cleveland Clinic Case Number 5 CBULP 2010 001 Case Based Urology Learning Program Editor: Associate Editor:
More informationRenal masses - the role of diagnostic imaging
Renal masses - the role of diagnostic imaging Poster No.: C-2471 Congress: ECR 2015 Type: Educational Exhibit Authors: V. Rai#; Bjelovar/HR Keywords: Cysts, Cancer, Structured reporting, Ultrasound, MR,
More informationJMSCR Vol 06 Issue 02 Page February 2018
www.jmscr.igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 71.58 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i2.08 Pattern of Renal Tumors: A Tertiary
More informationCase Based Urology Learning Program
Case Based Urology Learning Program Resident s Corner: UROLOGY Case Number 18 CBULP 2011 041 Case Based Urology Learning Program Editor: Associate Editors: Manager: Case Contributors: Steven C. Campbell,
More informationHow To Approach Renal Masses? - Differential Diagnosis On Image
How To Approach Renal Masses? - Differential Diagnosis On Image Poster No.: C-1646 Congress: ECR 2015 Type: Educational Exhibit Authors: A. E. A. G. Costa, A. Gomes, A. Duarte, I. Távora; Lisbon/PT Keywords:
More informationPDF created with pdffactory Pro trial version
Neuroblastoma Tumor derived from neural crest cell that form the sympathetic ganglia&adrenal medulla. Causes *unknown. *familial neuroblastoma has been reported but is rare. * The incidence is 1:100,000
More information1. Congenital Anomalies of Kidney and Ureter 1
CONTENTS 1. Congenital Anomalies of Kidney and Ureter 1 1.1 Antenatal Pelviureteric Junction Obstruction 1 1.2 Bilateral Pelviureteric Junction Obstruction 3 1.3 Circumcaval Ureter 6 1.4 Crossed Renal
More informationThe new TNM staging for renal cell carcinoma: what and why the urologists want to know.
The new TNM staging for renal cell carcinoma: what and why the urologists want to know. Poster No.: C-1132 Congress: ECR 2011 Type: Educational Exhibit Authors: Y. Y. Lim, A. Hattab, A. Bradley ; Manchester/UK,
More informationThe Natural History of Cerebellar Hemangioblastomas in von Hippel-Lindau Disease
AJNR Am J Neuroradiol 24:1570 1574, September 2003 The Natural History of Cerebellar Hemangioblastomas in von Hippel-Lindau Disease Andrew Slater, Niall R. Moore, and Susan M. Huson BACKGROUND AND PURPOSE:
More informationRenal Cystic Disease. Dr H Bierman
Renal Cystic Disease Dr H Bierman Objectives Be able to diagnose renal cystic disease Genetic / non-genetic Be able to describe patterns of various renal cystic disease on routine imaging studies Be able
More informationPersonal data. Age : 63 Gender : male
Personal data Age : 63 Gender : male Chief complain No specific symptom or discomfort A hepatic mass, found by abdominal sonography of routine health exam on 88-12-08 Past history 1984-3-3 Old CVA with
More informationperformed to help sway the clinician in what the appropriate diagnosis is, which can substantially alter the treatment of management.
Hello, I am Maura Polansky at the University of Texas MD Anderson Cancer Center. I am a Physician Assistant in the Department of Gastrointestinal Medical Oncology and the Program Director for Physician
More informationMULTILOCULAR CYSTIC RENAL CELL CARCINOMA
MULTILOCULAR CYSTIC RENAL CELL CARCINOMA Khalaf M. Al-Jader, MD* ABSTRACT Objective: Multilocular cystic renal cell carcinoma appears to be uncommon subtype of renal cell carcinoma with characteristic
More informationImpact of Weather on presentation of Kidney Tumour: a thirteen years Retrospective Study
Impact of Weather on presentation of Kidney Tumour: a thirteen years Retrospective Study F. Agha ( Pakistan Medical Research Council, CRC, National Institute of Health, Islamabad. ) K. Anwar,N. Akhter
More informationDaniela Faivovich K., MS VII Universidad de Chile Gillian Lieberman, MD Harvard Medical School
Daniela Faivovich K., MS VII Universidad de Chile Gillian Lieberman, MD Harvard Medical School May 21st, 2010 56 year old male patient History of hypertension, hyperlipidemia and insulin-resistance 2009:
More informationSt. Dominic s Annual Cancer Report Outcomes
St. Dominic s 2017 Annual Cancer Report Outcomes Cancer Program Practice Profile Reports (CP3R) St. Dominic s Cancer Committee monitors and ensures that patients treated at St. Dominic Hospital receive
More informationBladder Case 1 SURGICAL PATHOLOGY REPORT. Procedure: Cystoscopy, transurethral resection of bladder tumor (TURBT)
Bladder Case 1 February 17, 2007 Specimen (s) received: Bladder Tumor Pre-operative Diagnosis: Bladder Cancer Post operative Diagnosis: Bladder Cancer Procedure: Cystoscopy, transurethral resection of
More informationQuiz. b. 4 High grade c. 9 Unknown
Quiz 1. 10/11/12 CT scan abdomen/pelvis: Metastatic liver disease with probable primary colon malignancy. 10/17/12 Colonoscopy with polypectomy: Adenocarcinoma of sigmoid colon measuring at least 6 mm
More informationCase report. Open Access. Abstract
Case report Bilateral synchronous occurrence of three different histological types of renal tumor: a case report Demetrios Radopoulos, Anastasios Tahmatzopoulos*, Nikolaos Kalinderis and Georgios Dimitriadis
More informationPrimary Squamous Cell Carcinoma Of Kidney - A Case Report And Review Of Literature.
ISPUB.COM The Internet Journal of Nephrology Volume 6 Number 1 Primary Squamous Cell Carcinoma Of Kidney - A Case Report And Review Of Literature. P Kaur, A Chauhan, G Singh, S Kataria, R Kalra Citation
More informationKidney Case 1 SURGICAL PATHOLOGY REPORT
Kidney Case 1 Surgical Pathology Report February 9, 2007 Clinical History: This 45 year old woman was found to have a left renal mass. CT urography with reconstruction revealed a 2 cm medial mass which
More informationGenitourinary Neoplasms Updated for 2012 Requirements and CSv02.04
Presentation Outline Genitourinary Neoplasms Updated for 2012 Requirements and CSv02.04 X:\FCDS_PUB\wwwroot\downloads\Teleconfere nces\2013 FCDS Educational Webcast Series February 28, 2013 General Information
More informationGenitourinary Neoplasms Updated for 2012 Requirements and CSv02.04
Genitourinary Neoplasms Updated for 2012 Requirements and CSv02.04 X:\FCDS_PUB\wwwroot\downloads\Teleconfere nces\2013 FCDS Educational Webcast Series February 28, 2013 1 Steven Peace, BS, CTR Susan Smith
More informationUpdate on RECIST and Staging of Common Pediatric Tumors Ethan A. Smith, MD
Update on RECIST and Staging of Common Pediatric Tumors Ethan A. Smith, MD Section of Pediatric Radiology C.S. Mott Children s Hospital University of Michigan ethans@med.umich.edu Disclosures No relevant
More informationWhen to Integrate Surgery for Metatstatic Urothelial Cancers
When to Integrate Surgery for Metatstatic Urothelial Cancers Wade J. Sexton, M.D. Senior Member and Professor Department of Genitourinary Oncology Moffitt Cancer Center Case Presentation #1 67 yo male
More informationTraumatic and Non Traumatic Adrenal Emergencies
Traumatic and Non Traumatic Adrenal Emergencies Michael N. Patlas, MD, FRCPC (1), Christine O. Menias, MD (2), Douglas S. Katz, MD, FACR (3), Ania Z. Kielar, MD, FRCPC (4), Alla M. Rozenblit, MD (5), Jorge
More informationBLADDER TUMOURS A REVIEW OF 150 PATIENTS TREATED AT THE INSTITUTE OF UROLOGY AND NEPHROLOGY GENERAL HOSPITAL KUALA LUMPUR
Med. J. Malaysia Vol. 38. No. I March 1983. BLADDER TUMOURS A REVIEW OF 150 PATIENTS TREATED AT THE INSTITUTE OF UROLOGY AND NEPHROLOGY GENERAL HOSPITAL KUALA LUMPUR ZAKRIYA MAHAMOOTH HUSSAIN AWANG SUMMARY
More informationBJUI. Solitary, isolated metastatic disease to the kidney: Memorial Sloan-Kettering Cancer Center experience
; 2010 Urological Oncology SOLITARY, ISOLATED METASTATIC DISEASE TO THE KIDNEY ADAMY ET AL. BJUI Solitary, isolated metastatic disease to the kidney: Memorial Sloan-Kettering Cancer Center experience Ari
More informationPERSISTANT MULLERIAN DUCT SYNDROME ASSOCIATED WITH TRANSVERSE TESTICULAR ECTOPIA
PERSISTANT MULLERIAN DUCT SYNDROME ASSOCIATED WITH TRANSVERSE TESTICULAR ECTOPIA Dr. Abdulrahman A. Al-Bassam, FRCS(Ed) Assistant Professor & Consultant Paediatric Surgeon King Khalid University Hospital
More informationExcretory urography (EU) or IVP US CT & radionuclide imaging
Excretory urography (EU) or IVP US CT & radionuclide imaging MRI arteriography studies requiring catherization or direct puncture of collecting system EU & to a lesser extent CT provide both functional
More informationPartial Nephrectomy Planning: Everybody s s doing it, you can to
Partial Nephrectomy Planning: Everybody s s doing it, you can to Brian R. Herts, MD Associate Professor of Radiology Head, Abdominal Imaging, Imaging Institute & Staff, The Glickman Urological and Kidney
More informationImpact of lymphadenectomy in management of renal cell carcinoma
Journal of the Egyptian National Cancer Institute (2012) 24, 57 61 Cairo University Journal of the Egyptian National Cancer Institute www.nci.cu.adu.eg www.sciencedirect.com ORIGINAL ARTICLE Impact of
More informationINDEX. Note: Page numbers of issue and article titles are in boldface type. cell carcinoma. ENDOCRINE SURGERY
ENDOCRINE SURGERY INDEX Note: Page numbers of issue and article titles are in boldface type. Adenylate cyclase, in signal transduction 425-426 Adrenal incidentalomas, 499-509 imaging of, 502-504 in patients
More informationRENAL CANCER GUIDELINES
Greater Manchester and Cheshire Cancer Network RENAL CANCER GUIDELINES Agreed by Urology CSG: July 2010 Review Date: July 2012 Renal Cancer Guidelines 1. Introduction 1.1 Kidney cancer accounts for 3%
More informationImaging characterization of renal clear cell carcinoma
Imaging characterization of renal clear cell carcinoma Poster No.: C-0327 Congress: ECR 2011 Type: Educational Exhibit Authors: S. Ballester 1, A. Gaser 2, M. Dotta 1, M. F. CAPPA 1, F. Hammar 1 ; 1 2
More information25 TH ICRO DEHRADUN STAGING OF GENITOURINARY MALIGNANCIES
25 TH ICRO DEHRADUN STAGING OF GENITOURINARY MALIGNANCIES SPEAKER DR DEEPAK ABROL CLINICAL ONCOLOGIST JAND K HEALTH SERVICES CONSULTANT ONCOLOGIST MAHARISHI DAYANAND HOSPITAL AND MEDICAL RESEARCH CENTER
More informationRenal Mass Biopsy: Needed Now More than Ever
Renal Mass Biopsy: Needed Now More than Ever Stuart G. Silverman, MD, FACR Professor of Radiology Harvard Medical School Director, Abdominal Imaging and Intervention Brigham and Women s Hospital Boston,
More informationPrimary Synovial Sarcoma of the Kidney: a case report
Chin J Radiol 2004; 29: 359-363 359 Primary Synovial Sarcoma of the Kidney: a case report YU-KUN TSUI 1 CHUNG-JUNG LIN 1 JIA-HWIA WANG 1,4 SHU-HUEI SHEN 1,4 CHIN-CHEN PAN 2,4 YEN-HWA CHANG 3,4 CHENG-YEN
More informationUICC TNM 8 th Edition Errata
UICC TNM 8 th Edition Errata ions are in italics Head and Neck Tumours Pages 20, p27, p34, p38, p41, and p49 ly pn2a Metastasis in a single ipsilateral lymph node, less than 3cm in greatest dimension with
More informationUnusalPresentationofMetastasisfromaRenalCellCarcinoma-A CaseReportwithReviewofLiterature
Global Journal of Medical Research: K Interdisciplinary Volume 18 Issue 8 Version 1.0 Type: Double Blind Peer Reviewed International Research Journal Publisher: Global Journals Online ISSN: 2249-4618 &
More informationClinical Symptoms Predict Poor Overall Survival in Chronic-dialysis Patients with Renal Cell Carcinoma Associated with End-stage Renal Disease
Jpn J Clin Oncol 2014;44(11)1096 1100 doi:10.1093/jjco/hyu117 Advance Access Publication 19 August 2014 Clinical Symptoms Predict Poor Overall Survival in Chronic-dialysis Patients with Renal Cell Carcinoma
More informationCT and Angiography in Adrenocortical Carcinoma
Acta Radiologica ISSN: 024-151 (Print) 1600-0455 (Online) Journal homepage: https://www.tandfonline.com/loi/iard20 CT and Angiography in Adrenocortical Carcinoma F. Kolmannskog, A. Kolbenstvedt & I. B.
More informationRare Metastatic Sites in mrcc: A Different Disease? Gerald H. Mickisch Center of Operative Urology Bremen, Germany
Rare Metastatic Sites in mrcc: A Different Disease? Gerald H. Mickisch Center of Operative Urology Bremen, Germany Incidence of RCC in Europe Approx 12 per 100000. Variation from geographic region, country,
More informationManagement of Locally Reccurent Renal Cell Carcinoma. Jose A. Karam, MD, FACS Assistant Professor Department of Urology
Management of Locally Reccurent Renal Cell Carcinoma Jose A. Karam, MD, FACS Assistant Professor Department of Urology DefiniAons Defini&ve treatment Aiming for cure Abla&on therapy Radiofrequency abla&on
More informationBronchogenic Carcinoma
A 55-year-old construction worker has smoked 2 packs of ciggarettes daily for the past 25 years. He notes swelling in his upper extremity & face, along with dilated veins in this region. What is the most
More information