[Multifocal renal carcinoma: anatomic-clinical aspects]

Area of Science:

• Urology
• Oncology
• Pathology

Background:

• Renal cell carcinoma (RCC) is a significant health concern.
• Surgical management of RCC often involves nephrectomy.
• Understanding the prevalence of multifocal RCC is crucial for treatment planning.

Purpose of the Study:

• To determine the incidence of multifocal renal cell carcinoma in kidneys treated with nephrectomy.
• To evaluate the relationship between tumor size and multifocality.
• To inform surgical decision-making for small renal masses.

Main Methods:

• Histological examination of 387 kidneys post-nephrectomy for renal cell carcinoma.
• Serial sectioning of kidneys at 5 mm intervals.
• Analysis of cortical and intraparenchymal nodules for malignancy.

Main Results:

• Multifocal renal cell carcinoma was identified in 12 out of 387 (3%) kidneys.
• Only 3 cases presented with clinically apparent tumors measuring up to 3 cm.
• A significant proportion of multifocal disease may be occult.

Conclusions:

• Partial nephrectomy is a recommended approach for small renal cell carcinoma when the contralateral kidney is healthy.
• The findings support aggressive surveillance and early intervention for small renal masses.
• Histological assessment reveals a higher incidence of multifocal RCC than clinically detected.