Clinicopathologic Patterns of Adult Renal Tumors in Pakistan

Abstract

<b>Background:</b> Renal cancer is a serious public health problem which may be under reported and registeredin our setup, since the Karachi cancer registry documented only 43 cases out of 4,268 incident cancer cases over3 year duration. Therefore we aimed to determine the clinicopathologic characteristics of adult renal tumors inour setup. Materials and <br/><b>Methods</b>: The study was conducted in histopathology department, Liaquat NationalHospital and included total of 68 cases of adult renal tumors over 4 years. Detailed histopathologic characteristicsof tumors were analyzed. <br/><b>Results</b>: Mean age of patients was 56.4 (18-84) years. Renal cell carcinoma (RCC) wasthe most common cell type (78%) cases; followed by transitional/urothelial carcinoma (12.5%), leiomyosarcoma(4.7%), oncocytoma (1.6%), squamous cell carcinoma (1.6%) and high grade pleomorphic undifferentiatedsarcoma (1.6%). Among 50 RCC cases; 62% were conventional/clear cell RCC (CCRCC) type followed bypapillary RCC(PRCC), 24%; chromophobe RCC(CRCC), 6% and sarcomatoid RCC(SRCC), 8%. Mean tumorsize for RCC was 7.2 cm. Most RCCs were intermediate to high grade (60% and 40% respectively). Capsularinvasion, renal sinus invasion, adrenal gland involvement and renal vein invasion was seen in 40%, 18%, 2% and10% of cases respectively. <br/><b>Conclusions</b>: We found that RCC presents at an earlier age in our setup compared toWestern populations. Tumor size was significantly larger and most of the tumors were of intermediate to highgrade. This reflects late presentation of patients after disease progression which necessitates effective measuresto be taken in primary care setup to diagnose this disease at an early stage.