ABSTRACT
Background: Primary renal cancer accounts for 10 - 20of all genito-urinary tract malignancies. The present study determined its clinico-pathological pattern and outcome of management. Methods: All patients with malignancies of the kidney seen between January 1999 and December 2007 were included in the study. These patients had surgery alone or in combination with preoperative/postoperative chemotherapy or radiotherapy and all specimens were confirmed malignant on histopathological examination. Results: Forty-nine patients with renal malignancies were seen of which 26(55.1) were males and 23(44.9) were females. The adults comprised 30(61.2) and children 19(38.8). The mean age was 27.60 +/- 22.12 years (range 7months-70 years). The male: female ratio was 1.1:1 and the mean duration of symptoms was 12.56 months (range 1-48 months). The most frequent clinical features were loin pain; 17 (44.7); and flank mass; 32(84.2). Others included haematuria; 13(34.2); fever; 19(50.0) and anaemia; 15(39.5). The main diagnostic investigations were ultrasonography and intravenous urography. Forty-seven (95.9) patients underwent radical unilateral nephrectomy and 2(4.1) had debulking or lymph node biopsies because of non-resectable tumours. These two had chemotherapy and subsequent nephrectomy. The most frequent renal malignancy was renal cell carcinoma (44.9) followed by nephroblastoma (38.8) which accounted for all the childhood renal tumours. All the children with nephroblastoma had postoperative 17(89.5) or preoperative 2(10.5) combination chemotherapy. Common postoperative complications included anaemia; fever; and chest and wound infections. There were 3 known deaths (mortality rate of 6.1). The main cause of death was advanced malignancy. Conclusions: Renal cell carcinoma is the most frequent malignant tumour of the kidney in the study population. Late presentation resulted in in-operable tumours with poor survival despite neo-adjuvant chemotherapy