Ces Urol 2002, 6(1):26-31 | DOI: 10.48095/cccu2002007

Papillary renal carcinoma

M. Hora¹, O. Hes², L. Boudová², Z. Chudáček³, Z. Ouda¹, M. Michal², M. Roušarová⁴

Lékařská fakulta Univerzity Karlovy a Fakultní nemocnice v Plzni

¹ urologická klinika

² Šiklův patologicko-anatomický ústav

³ radiodiagnostické oddělení

⁴ Národní onkologický registr

Papillary renal carcinoma (PRC) is in comparison with conventional renal carcinoma (CRC) from many aspects different variety of renal carcinoma (RC). The aim of this paper is evaluation of own group of patients with PRC oriented to morphological differences from other types of RC in preoperative imaging examinations with special care of malignant potential of PRC.

Material and methods: 489 renal tumours of 477 patients were examined from 1/1991 to 8/2001 in The Department of Urology, Univesity Hospital Pilsen. RC was found in 448 tumours, mainly CRC. PRC was diagnosed in 4.7% (21/448) of RC and it was second most common after the CRC. Trird most common tumour was chromophobical RC in 2.0% (9/448). Further evaluation of group of 21 patients with PRC was done.

Results: Males were affected more often (2:1) Average age has been 59.9 ? 14.8 years.
The youngest was 17.8 years. Typical necrotic changes in tumour often emulated on ultrasound examination or CT scan pathologicaly changed cyst and appeared as avascular expansion in angiography Twice (9.5%) tumour was diagnosed when had ruptured. Tumour was multifocal in 143% (3/21) cases. Average follow up was 47 months (5 - 100 months). Five years follow up was known in 12 cases (dead included). Three patiens has died but only two because of generalisation. Specific five years survival rate was 81.8% (9/11).

Conclusion: Appearance of PRC is influenced by necrotic changes on diagnostic imaging techniques (USG, CT) and diagnosis can be difficult. Operative revision is always necessary. Malignant potential of PRC is lower than that of CRC. Poorly his-tologically differentiated PRC (grade 3), with more than 75 mm in diameter and probably multifocal PRC are in risk of generalisation.

Keywords: Renal carcinoma (papillary), Ultrasonography, CT, Prognosis

Published: January 1, 2002