[Incidental renal cell carcinoma: clinical and morphological features].

This article is devoted to the evaluation of features of incidental, or asymptomatic renal cell carcinoma (RCC). The study included 268 patients with RCC aged 25 to 92 years who underwent examination and treatment in the urological clinic MRSRCI for the last 5 years. 163 (60.8%) patients had incidental renal tumors (Group 1), 105 (39.2%)--symptomatic renal tumors (Group 2). In incidental renal tumors, tumor nodule was smaller compared with symptomatic RCC--5,74 +/- 3.0 vs 6.4 +/- 3.6 cm. Stage I and II disease was diagnosed in 130 (79.7%) patients in Group 1 and only in 69 (65.7%) patients in Group 2 (P < 0.05). No significant differences in the distribution of the degree of nuclear atypia according Fuhrman nuclear grade were identified. The organ preservation surgery were performed more frequently in incidental RCC than in symptomatic RCC, in 47 (28.9%) and 21 (20%) cases, respectively; in addition, regional and distant metastases were diagnosed less frequently. With this in mind, it should be suggested that incidental tumors have a better prognosis than tumors with clinical manifestations.

[Comparative clinical and morphological characteristics of incidental and symptomatic renal cell carcinoma].

Over the last two decades, marked increase in detection of incidental or asymptomatic renal cell carcinoma (RCC) in developed countries was observed. The study included 268 patients aged from 25 to 92 years with RCC, which underwent evaluation and treatment in urology clinic MRSRCI for the past 5 years. There were no significant differences in the frequency of histological types of RCC between incidental and symptomatic tumors. Among incidental neoplasms with clear- cell structure, tumor with small size--up to 4 cm (T1a stage) and moderate to high degree of differentiation (G 1-2 according Fuhrman) were predominant. Papillary variant of RCC was detected at a higher stage of the disease and characterized by a high degree of nuclear atypia, which indicates its high malignant potential. Chromophobe RCC was usually diagnosed at T3 stage. The average age of men and women with chromophobe RCC was 46.5 +/- 6.8 years; there were no age difference in patients with symptomatic and incidental RCC. Among the benign tumors of the kidneys, angiomyolipoma was most commonly diagnosed--in 13 (53.8%) cases. Thus, incidental tumors have a better prognosis than symptomatic tumors.