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[A clinico-pathological study of renal cell carcinoma with a diameter of less than 5 cm]
Abstract:
To examine the indication of nephron sparing operations, we searched 31 nephrectomized kidneys with renal cell carcinoma for small associated lesions in the normal-appearing portion of these kidneys. The diameter of the predominant tumors was between 15 and 50 mm. The kidneys were serially sectioned at 5-mm intervals, and all sections were examined microscopically. Two of the 31 kidneys had a small renal cell carcinoma, and four had a small adenoma in the normal-appearing portion. We recommend that the nephron-sparing operation should be is performed limitedly and that radical nephrectomy is yet a standard operation in the presence of a normal contralateral kidney.
Insights
Nephron-sparing surgery for renal cell carcinoma is recommended sparingly. Radical nephrectomy remains the standard treatment when the contralateral kidney is healthy, as small lesions are uncommon in normal kidney tissue.
Area of Science:
- Urology
- Nephrology
- Oncology
Context:
- Renal cell carcinoma (RCC) management.
- Evaluation of nephron-sparing surgery (NSS) indications.
- Microscopic examination of kidneys post-nephrectomy.
Purpose:
- To investigate the frequency of small renal lesions in normal-appearing kidney tissue from patients with renal cell carcinoma.
- To assess the suitability of nephron-sparing operations based on these findings.
Summary:
- 31 nephrectomized kidneys with predominant tumors (15-50 mm) were serially sectioned and microscopically examined.
- Two kidneys (6.5%) contained small renal cell carcinomas in normal-appearing portions.
- Four kidneys (12.9%) showed small adenomas in normal-appearing portions.
Impact:
- Findings suggest limited indications for nephron-sparing surgery in renal cell carcinoma.
- Radical nephrectomy remains the standard surgical approach for renal cell carcinoma when the contralateral kidney is normal.
- Highlights the low prevalence of incidental small renal tumors in otherwise normal kidney parenchyma.