Value of enucleation of tumor in solitary kidneys

An untreated malignancy of an anatomic or functional single kidney is fatal. However, tumor enucleation, including examination of the abscission surfaces by immediate per operative section should be considered as a curative treatment. Of 15 patients who underwent tumor enucleation during the past 10 years, 1 died of postoperative complications, while 3 patients died of tumor progression; 9 are alive at 9-49 months with no evidence of disease, and 2 are alive, one with a metastasis and the other with a locoregional relapse in the contralateral kidney bed. Because of the low incidence of complications, superficial hypothermia with ice should be preferred to extracorporeal surgery. The characteristic pseudocapsule allows an enucleation of the malignoma with protection of vessels and optimal preservation of the healthy parenchyma.