[Renal cell carcinoma--diagnosis, differential diagnosis and prognosis]

Consideration of the approach to the diagnosis and differential diagnosis of renal cell carcinoma and the criteria needed for an assessment of prognosis.

Thanks to the comprehensive use of ultrasonography and abdominal CT, asymptomatic renal cell carcinomas confined within the renal capsule are now more often being discovered and treated by curative surgery. With the aid of ultrasonography, abdominal CT and NMR imaging, pre-operative visualization of tumor spread is now better, although, with the exception of angiomyolipoma, it is still not possible to adequately differentiate the rare benign tumors of the kidney, for example oncocytoma, from renal cell carcinomas with these procedures. The TNM classification permits a highly differentiated prognostic classification of the renal cell carcinomas. The additional prognostic parameters, triploidy and hypertetraploidy determinable by flow cytophotometry, are also considered.

Early detection of renal cell carcinomas in an asymptomatic stage decisively influences the further prognosis, so that for all upper abdominal ultrasonographic explorations, performed for whatever reason, attention should be paid to such incidental findings.