1987 Volume 78 Issue 11 Pages 1895-1899
From January 1957 to December 1984, 301 patients with renal cell carcinoma were treated at the Jikei University Hospital and related hospitals. The cases were classified as to whether the renal tumor was diagnosed before or after 1978. After 1978 the use of computed tomography (CT) increased greatly. We studied clinical characteristics of patients with non specific urinary tract symptoms or without any direct signs of renal cell carcinoma as an incidental finding.
In the pre-1978 group, 12 out of 123 (9.8%) cases were incidental findings. Out of 178 cases diagnosed after 1978, 37 (20.8%) were incidental. Then, the rate of incidental diagnosis was increasing in recent years (the period after 1978). There was no significant difference between the incidental cases of the two time periods in terms of the mean age, sex ratio, and affected side. The most common findings that led to the diagnosis in the incidental group were a fever of unknown origin, metastatic signs and gastrointestinal signs. The tests that most often led to the diagnosis were CT scan (46.9%), IVP, ultrasonography, and X-rays of the gastrointestinal tract.
Our data indicated that patients with incidentally-found tumors did not have a very low disease stage and, therfore, their survival rate was not much better than that of patients with the recognized signs and symptoms of renal cell carcinoma. With increasing use of effective tecniques such as CT scans and ultrasonography, the number of incidentally-found renal cell carcinoma will cotinue to increase. But renal cell carcinomas thus found are not always in an early stage.
