Rational approach to the treatment of a patient with a small renal cortical tumor

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Background A 64-year-old man with a history of hypertension and type II diabetes mellitus presented to his primary care physician for his annual health examination. Renal ultrasonography revealed a solid right renal mass, which was confirmed by MRI. The initial consultant recommended laparoscopic radical nephrectomy. The patient sought a second opinion.

Investigations Physical examination, baseline serum creatinine level, urine cytology, CT urogram and renal ultrasonography.

Diagnosis Centrally located subcortical tumor arising from the renal parenchyma.

Management Open partial nephrectomy. There were no intraoperative complications and the patient's postoperative course was uneventful.

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Figure 1: Baseline imaging studies.
Figure 2: Pathological analysis of the carcinoid.


  1. 1

    Russo P (2000) Renal cell carcinoma: presentation, staging, and surgical treatment. Semin Oncol 27: 160–176

  2. 2

    Jemal A et al. (2006) Cancer statistics, 2006. CA Cancer J Clin 56: 106–130

  3. 3

    Russo P (2006) Open partial nephrectomy: an essential contemporary operation. Nat Clin Pract Urol 3: 2–3

  4. 4

    Frank I et al. (2003) Solid renal tumors: an analysis of pathological features related to tumor size. J Urol 170: 2217–2220

  5. 5

    McKiernan J et al. (2002) Partial nephrectomy for renal cortical tumors: pathologic findings and impact on outcome. Urology 60: 1003–1009

  6. 6

    Dechet CB et al. (2003) Prospective analysis of computerized tomography and needle biopsy with permanent sectioning to determine the nature of solid renal masses in adults. J Urol 169: 71–74

  7. 7

    Lee CT et al. (2000) Surgical management of renal tumors 4 cm or less in a contemporary cohort. J Urol 163: 730–736

  8. 8

    Kattan MW et al. (2001) A postoperative prognostic nomogram for renal cell carcinoma. J Urol 166: 63–67

  9. 9

    Gill IS et al. (2003) Comparative analysis of laparoscopic versus open partial nephrectomy for renal tumors in 200 patients. J Urol 170: 64–68

  10. 10

    Ray ER et al. (2006) Open partial nephrectomy: outcomes from two UK centres. BJU Int 97: 1211–1215

  11. 11

    Hollingsworth JM et al. (2006) Rising incidence of small renal masses: a need to reassess treatment effect. J Natl Cancer Inst 98: 1331–1334

  12. 12

    Go AS et al. (2004) Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 351: 1296–1305

  13. 13

    Huang WC et al. (2006) Chronic kidney disease after nephrectomy in patients with renal cortical tumors: a retrospective cohort study. Lancet Oncol 7: 735–740

  14. 14

    Hollenbeck BK et al. (2006) National utilization trends of partial nephrectomy for renal cell carcinoma: a case of underutilization. Urology 67: 254–259

  15. 15

    Nuttall M et al. (2005) A description of radical nephrectomy practice and outcomes in England: 1995–2002. BJU Int 96: 58–61

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Correspondence to Paul Russo.

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