Unrecognized renal cell carcinoma. Clinical and diagnostic aspects

In a series of 16294 autopsies 350 cases of renal cell carcinoma were found. Of these tumours 235, i.e. two thirds, were unrecognized during lifetime. Metastatic spread was revealed in 56 patients (24%) with unrecognized renal cell carcinoma and was the main cause of death of 49 patients (21%). In 67 patients (33%) a second malignant tumour was observed causing the death of 47 patients (20%). Most patients died with rather than from the renal malignancy. The symptomatology as to the renal malignancy was generally poor. Haematuria, palpable mass, polycythemia and fever of unknown origin were less common findings in the present series as compared with fatigue, loss of weight and symptoms from metastatic sites.