Histopathologic Features of Bilateral Renal Cell Carcinomas: A Study of 24 Cases
J Abdelsayed, JY Ro, LD Truong, AG Ayala, SS Shen. The Methodist Hospital and Weill Medical College of Cornell University, Houston, TX
Background: The incidence of bilateral renal cell carcinoma (bRCC) has been reported to vary from 1.5% to 11%. Clear understanding of the clinicopathologic features of bRCCs including the distinction between synchronous and metachronous tumors has important implications in patients' management and follow up. The purpose of this study is to summarize the clinicopathologic features of bRCCs and compare them with those of unilateral renal cell carcinomas (uRCCs).
Design: Of the 1230 patients treated at our hospital for RCC from 1990 to 2006, 24 (2.0%) were found to have bRCCs. The clinicopathologic features of these patients were reviewed and compared with those of unilateral RCCs.
Results: There were no significant differences in gender or age (59.7 vs. 60.3 years) between patients with bRCCs or uRCCs. Of the 24 bRCCs, 13 were synchronous and 11 were metachronous tumors (with an average of 22.6 months after 1st tumor). Three patients had Von Hippel Lindau (VHL) syndrome. Overall, 21 of 24 bRCCs (87.5%) had the same histology, while in 3 patients with metachronous tumors, the 1st tumor was a clear RCC, and the contralateral tumor was a papillary RCC. The incidence of clear cell, papillary, and chromophobe RCC was 54.1%, 41.6%, and 4.2% respectively for bilateral RCC, compared to 77.2%, 15.2%, and 5.6% for unilateral RCC. Six of 13 pts with synchronous tumors died within an average time of 22.6 month, contrasting with 2 of 11 patients with metachronous tumors died at an average time of 102.8 month.
Conclusions: In this series, the incidence of bilateral RCC was 2.0%. VHL disease accounted for 14.2% of bRCC. The incidence of papillary RCC in patients with bRCC was much higher than in patients with uRCCs (41.6% vs. 15.0%). Our study also indicates that patients with synchronous tumors have worse survival than patients with metachronous tumors.
Category: Genitourinary (including renal tumors)
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 147, Tuesday Morning