PATTERN OF PRESENTATION OF RENAL CELL CARCINOMA AT INSTITUTE OF KIDNEY DISEASES, PESHAWAR

Objective: To study the pattern of presentation of patients with renal cell carcinoma.Methodology: This descriptive study was conducted at Institute of Kidney Diseases, Hayatabad Medical Complex Peshawar-Pakistan from January to December 2012. All patients who were diagnosed as renal masses on ultrasound were admitted. Detailed history and physical examination was performed on all patients. Relevant investigations were done on all patients.Results: A total of 65 patients with renal cell carcinoma were included in the study. Patients presented with flank pain (n=30, 46%); hematuria (n=14, 22%); flank mass (n=2, 3%); both hematuria and flank pain (n=3, 5%); incidental tumors (n=10, 15%); and with metastasis (n=6, 9%). The tumors were located on right side in 39 (60%) cases and 26 (40%) on left side with 80% of the tumors involving the upper pole of the kidney. Twenty six patients (40%) were cigarettes smokers. No patient was found to have positive family history of renal cell carcinoma or any other cancer in the close family. Fifty nine patients with renal tumors underwent radical nephrectomy and histopathology was done of every specimen. In six patients of renal tumor with metastasis, needle biopsy was taken. The histopathology of the specimen showed that 61 (94%) were clear cell type and 4 (6%) were papillary cell carcinoma.Conclusion: Renal cell carcinoma presents with a variety of symptoms. It can also present incidentally during investigation for non-specific symptoms. Ultrasonography is encouraged for nonspecific abdominal symptoms to detect renal cell carcinoma at earlier stage.