The International Society of Urologie Pathology 2012 Conference on renal cancer discussed the staging and specimen handling of renal tumors. For specimen handling, the initial cut should be made along the long axis. Renal tumors should be sampled 1 block/cm with a minimum of 3 blocks. The length of a renal vein/caval thrombus should not be part of main tumor measurement. In cases with multiple tumors, sampling should include a minimum of 5 largest tumors. Perinephric fat invasion should be determined by examining multiple perpendicular sections of the tumor/perinephric fat interface and by sampling areas suspicious for invasion. Perinephric fat invasion was defined as either the tumor touching the fat or extending as irregular tongues into the perinephric tissue, with or without desmoplasia. Renal sinus invasion is present when the tumor is in direct contact with the sinus fat or the loose connective tissue of the sinus, clearly beyond the renal parenchyma, or if any endothelium-lined space is involved within the renal sinus, regardless of the size. When invasion of the sinus is uncertain, at least 3 blocks of tumor-renal sinus interface should be submitted. If invasion is grossly evident, or obviously not present, only 1 block is needed.