Renal Cell Carcinoma: Clinical Aspects and Natural History
We teach our medical students that the presenting features of an adenocarcinoma of the kidney are haematuria, pain and a mass that has been noticed either by the patient or the doctor. We make the diagnosis by discovering a mass in the urogram that is solid in the ultrasound scan, typically vascular in the angiogram, or characteristically dense in the CAT scan. Pathologists tell us that one can tell a cancer of the kidney from a benign adenoma not by the histological features of either of them, but by their size — tumours smaller than 3 cm. in diameter being deemed benign, larger ones malignant. Treatment is nephrectomy: it is true that many of us have added other adjuvant agents from time to time, but it is equally true that none of them are (so far) of proven value. This is the conventional wisdom. We thought it would be of value to examine these well established truths in the light of the clinical experience of one centre over the last 15 years.
KeywordsRenal Cell Carcinoma Partial Nephrectomy Conventional Wisdom Renal Carcinoma Medroxyprogesterone Acetate
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