​Updated 3 July 2007

Clinico-pathologic Considerations

Most renal tumours in adults are renal cell carcinomas, and discussion elsewhere refers to this histologic type. However it is essential not to overlook the possibility of a more treatable histology in a younger patient or where any atypical clinical features are present. These unusual tumours include:

1. Transitional cell carcinomas of renal pelvis
2. Lymphomas (see Lymphoma section of this manual)
3. Sarcomas (consider referral to Sarcoma service)
4. Adult Wilms' tumour

These tumours require individualized management.

Radical Nephrectomy Specimens Should Include the Following Information:

Gross Description

1. The size of the kidney (three dimensions)
2. The length of attached ureter
3. The size of any tumour mass and the size of any satellite nodules
4. The location of any tumour masses
5. The relationship to capsule, to the renal pelvis and to the renal vessels
6. The presence of tumour within the renal vein

Microscopic Description

1. Histologic classification:
   

   clear cell carcinoma

   papillary carcinoma

   chromophobe carcinoma

   oncocytoma

2. Presence or absence of vascular invasion
3. The invasion of capsule, renal pelvis, perirenal fat
4. The status of all resection margins
5. Lymph nodes status
6. Fuhrman nuclear grade (1 - Well, 2-3 - Moderate, 4 - Poor)