A Clinical Observation on Adenocarcimoma of the Kidney

Lee, Sang Taek

Abstract

A clinical observation was made on 25 cases of renal adenocarcinoma admitted to the Department of General Surgery and Urology, National Medical Center, Seoul, Korea, during the period from January. 1963 to December. 1977. The following results were obtained : 1) The range of age was from 25 to 66. The most prevalent age group of renal adenocarcinoma was 50 to 59 (36%). The male and female ratio was 1.8 : 1. 2) 6 cases or 248 of 25 cases visited to hospital from one to six months after the occurrence of initial disturbance and 5 cases from 1 year to 2 years. 3) Among the symptoms on admission, hematuria was in 15 cases (60%), mass in 10 cases (40%) and flank pain in 7 cases (28%) 4) On the physical examination, abdominal mass was in 13 cases (52%), abdominal tenderness in 9 cases (36%) and hypertension in 8 cases (32%). On the laboratory examination, anemia was in 9 cases (36%), erythrocytosis in 2 cases and elevation of ESR in 8 cases (32%) 5) On the urograms , the non-visualization of the kidney was found in 6 cases (20%) and poor visualization in 7 cases (28%), Flattening , elongation, narrowing, and irregular filling defect of the pelviocalyces were found in 9 cases (36%) while elongation of one or more calyces noted in 2 cases . 6) The degree of vascularity on angiography revealed avascularity in 1 case, minimal vascularity in 2 cases, moderate vascularity in 3 cases and marked vascularity in 19 case (76%). 7) The right kidney was involved in 12 cases and left kidney in 13 cases. The upper pole was involved in 9 cases (36%), lower pole in 7 cases (28%), midportion in 4 cases and diffuse involvement was 5 cases. 8) The pathological staging was done in 22 of 25 cases. The Results revealed stage I in 5 cases, stage II in 2 cases, stage III in 6 cases and stage IV in 9 cases. 9) The histological type of 20 cases revealed clear cell in 10 cases, granular cell in 4 cases and mixed variety in 6 cases. 10) There were 4 cases of lung metastasis which were the most common metastatic involvement and 2 cases of vone metastasis. 11) Nephrectomy was performed on 18 cases, combined treatment with nephrectomy and chemotherapy was undergone in 2 cases and palliative treatment in 5 cases. 12) 1-year survival rate was 43.1%(7/16) and 5-year survival rate 7.7%(1/13).