Neoplasias renais em nefrectomias realizadas no período de 1990 a 2006 na Universidade Federal do Triângulo Mineiro

Abstract

From January 1990 to December 2006 62 nephrectomies were carried out at UFTM due to neoplasias. Biopsies were reviwed according to the 2004 OMS classification. There were 40 (64,5%) cases of renal cell carcinoma (RCC), 9 (14,5%) benign tumors, 6 (9,6%) nephroblastomas, 4 (6,4%) urothelial carcinoma and 1 (1,5%) case of each of the following diagnoses: neuroblastoma, Ewing s sarcoma and synovial sarcoma. From the 40 patients with RCC, 27 (67,5%) were male. Mean age was 59,1 years old, ranging from 36 to 82 years. Sixteen (40%) patients were smokers. Radical nephrectomy was performed in 37 (92,5%) of the patients. Tumor was in the left kidney in 25 patients (62,5%). Twenty-five (62,5%) from the 40 patients were symptomatic during diagnostic. There were 25 RCC conventional cases, 7 cases of papillary RCC, 5 cases of chromophobe RCC, 1 case of RCC of the collecting ducts and 2 cases of non-classified RCC. Among the papillary carcinomas, there was a type I case and six type II cases. According to the Fuhrman s nuclear grades 5%, 37,5%, 35% and 22,5% of the cases were related to I, II, III and IV, respectively. Sarcomatoid alteration was found in 5 (12,55%) patients and microscopic angio-lymphatic invasion in 17,5% of the patients. Stages I, II, III and IV were 47,5%, 17,5%, 25% and 10%, respectively. Twenty-one (52,5%) patients with RCC were followed-up for a mean time of 42,5 months and did not present neoplasia evidences; in 8 (20%) patients there was recurrence or metastasis during the mean follow-up of 25,5 months. Nine (14,5%) benign tumors were observed, being 3 oncocytomas, 3 angiomyolipomas, 2 cystic nephromas and a mixed epithelial and stromal tumor. Seven neoplasias occurred in patients under the age of 17: 6 nephroblastomas and 1 neuroblastoma. Among the patients with nephroblastoma, 4 were male. Mean age of the patients was 54,3 months. All patients were symptomatic, being the main symptom a palpable mass. Tumors were predominantly blastematous in 4 patients, predominantly epithelial in one case and mixed in another one. Anaplasia was not observed in any of the tumors. According to the pathological staging, 1 patient was stage I, 4 were stage II and 1, stage IV.