[CT-staging of renal carcinoma]

In 38 cases of renal cell carcinoma computed tomographic (CT) findings concerning local tumour invasion (T), regional lymphnode involvement (N) and that of large veins (V) are compared with the pathological tumour staging (pT, pN, vein involvement). The local tumour invasion was correctly diagnosed with CT in 84% of the cases. Our experience is that CT finding, in regards to tumour infiltration into neighbouring organs, is more accurate the more dorsal these infiltrations lie. In the N-category, there is a tendency to overstage. For tumour involvement of the V. cava and V. renalis, CT findings are inaccurate; there angiography will be necessary to obtain important preoperative information and to determine the arterial blood supply of the tumour. After urographic and sonographic diagnosis of a solid renal parenchymal mass, CT comes next as diagnostic assessment. Angiographic examinations are not necessary with T 1/2-tumours, but with large renal tumours (T 3/4), abdominal aortography, selective renal arteriography and cavography are essential.