[Clinical evaluations of tumor enucleation for incidental renal cell carcinoma]

We performed tumor enucleation in 21 patients of renal tumors from Jan. 1980 to Feb. 1993. Of them 19 had renal cell carcinoma. We reviewed the results of clinical experiences. Preoperatively, all patient underwent ultrasound, computerized tomography (CT) and angiography, and evaluated tumor characteristics in terms of its localization, size and pre or absence of pseudocapsule. All cases were shown to be well encapsulated. Of them 17 were asymptomatic and detected incidentally, whereas remaining one case was bilateral renal cell carcinoma clinically characterized by gross hematuria. This case was treated by radical nephrectomy on the right side and enucleation of the tumor on the left side. All cases had localized renal cell carcinoma (stage 1) of low grade (15 cases of grade 1 and 3 of grade 2), and the diameter of the tumor averaged 3.4 cm. Of 18 cases 2 died, one died of causes unrelated to RCC and the other of the metastasis of bilateral RCC after nephrectomy. The 16 cases are presently free of disease for maximal follow up period of 92 months. We consider that tumor enucleation will be indicated for tumors found incidentally, surrounded by pseudocapsule, of small size (less than 3.0 cm in diameter), and of low grade and low stage, and that tumor enucleation for renal cell carcinoma could be curative yet preserve renal function in selected patients.