COMPARISON OF INCIDENTALLY DETECTED RCC VS SYMPTOMATIC: A SINGLE CENTER EXPERIENCE.

Abstract

OBJECTIVES: Renal cell carcinoma (RCC) is the most common malignancy of the kidney. Introduction and extensive application of modern imaging techniques, including ultrasonography, computed tomography(CT), and magnetic resonance imaging, have led to an increase in the number of incidentally discovered renal tumors. We analysed incidentally detected renal tumours with regard to their incidence, demographics and histopathology in a contemporary series and compared with symptomatic tumours. MATERIAL AND METHODS: The author reviewed the records of incidentally detected renal masses, treated surgically for suspicion of malignancy between January 2011 and March 2020.The incidence, demographics and histopathology were noted in both incidental and symptomatic tumours. RESULTS: Out of 244 renal masses, 67 cases were incidentally detected. Out of which, 48 (71.64 %) were men and 19 (28.36 %) were women, 34 ( 50.74%) were on the left side and 33 (49.26%) were on the right side. The mean size of incidental tumour was 6.2 cm, 27 (39.55%) partial nephrectomies were performed as compared to 10.1 % in symptomatic tumours (p=0.001%) . Out of these 67 renal masses, 7 (10.44 %) were benign, and 60 (89.56 %) were malignant. Among histopath subtypes, 47 ( 78.33%) were clear cell, 6 ( 10.00% ) were papillary, 3 ( 5.00% ) were chromophobe , 2 ( 3.33 % ) were collecting duct and 2 ( 3.33% ) were other malignancies. Fuhrman grade 2 was most common 31 (50.83 %) in these tumours . Stage T1 tumours were encountered in 93.3 % of incidental masses as compared to only 38.1% of symptomatic (p=0.001). CONCLUSIONS:The incidentally detected tumours are being diagnosed with increased frequency at lower stage (T1) and grade(grade 2).