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Updated: Jul 3, 2026
In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
Published on: March 30, 2015
Multifocal renal cell carcinoma: clinicopathologic features and outcomes for tumors </=4 cm
Paul L Crispen1, Christine M Lohse, Michael L Blute
1Departments of Urology, Mayo Clinic, Rochester, MN 55905, USA.
Abstract:
A significant increase in the incidental detection of small renal tumors has been observed with the routine use of cross-sectional abdominal imaging. However, the proportion of small renal tumors associated with multifocal RCC has yet to be established. Here then, we report our experience with the treatment of multifocal RCC in which the primary tumor was 4 cm. With the known incidence of multifocality RCC, careful inspection of the entire renal unit should be performed when performing nephron sparing surgery.
Insights
Multifocal renal cell carcinoma (RCC) is found in 5.4% of patients. Small multifocal RCC tumors showed similar survival rates to solitary tumors, emphasizing careful inspection during surgery.
Area of Science:
- Urology
- Oncology
- Radiology
Background:
- Incidental detection of small renal tumors is increasing due to routine cross-sectional imaging.
- The prevalence of multifocal renal cell carcinoma (RCC) among these small tumors remains unclear.
Purpose of the Study:
- To establish the proportion of small renal tumors (< =4 cm) associated with multifocal RCC.
- To analyze treatment and outcomes for multifocal RCC with primary tumors < =4 cm.
Main Methods:
- Retrospective analysis of 1113 renal cell carcinoma (RCC) patients.
- Evaluation of multifocality, histology, surgical approach, and survival outcomes.
Main Results:
- Multifocal disease was present in 5.4% of patients (60/1113).
- Discordant histology occurred in 17% of multifocal RCC cases.
- Nephron-sparing surgery was less frequent for multifocal tumors.
- Cancer-specific and metastasis-free survival were similar for multifocal and solitary tumors.
Conclusions:
- Multifocal RCC, even with small primary tumors, has comparable survival to solitary tumors.
- Careful inspection of the entire kidney is crucial during nephron-sparing surgery for suspected RCC.
