Introduction and Objectives
The positive and differential diagnostic, clasification, management and follow-up of renal oncocytoma still represent a subject of controversy. The aim of the study was to present our experience in managing oncocytoma.
Material and Methods
Beetwen June 1997 and January 2009 in our department were operated 72 patients with renal oncocytoma, 49 males and 23 females with an average of 64 years old. Clinical findings were minor, especially lumbar pain, hematuria (18 cases), fever (17 cases), abdominal pain and 39 cases were discovered incidentaly. Investigational protocol included: clinical examination, IVP, abdominal ultrasound with Doppler exam, CT and in some selected cases MRI and renal angiography. Prior to surgery, based on preoperative data, the diagnostic of renal oncocytoma was considered in 21 cases.
In our department, therapeutical atitude in RCC is radical trans-peritoneal nephrectomy. This procedure was performed in all cases, as long as the preoperative criteria for diagnose the oncocytoma remains unclear. Fine needle aspiration under CT control and nephron-sparing surgery were not performed. Clasification for tumors was as follows: T2 – 37 cases, T3a – 25 cases and T4 – 10 cases. We did not find lymph-nodes invasion or distant metastasis and standard lymphadenectomy was performed in all cases. Pathological examinatin indicated renal oncocytoma in all cases. Low-grade anaplastic oncocytoma was proved in 56 cases, 5 cases proved a combination of renal oncocytoma and angiomiolipoma and in 11 cases high-grade anaplastic renal oncocytoma were found. Postoperative complication were minor. Follow-up protocol included: clinical examination, ultrasound, CT and/or MRI, and was proceded at every 6 months in first 2 years and then yearly. No major complicatons were noticed.
In our center, renal oncocytoma respects the international incidence among renal tumors. Our attitude was radical nephrectomy – in all cases, considering that no preoperative investigation could certify the diagnosis. Evolution after surgery was good for all tumors despite the size, type or invasion. The confirmation of diagnostic was pathological. Short term and long term surviving rate after surgery was 100%.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.