Volume 5, Number 35; April 26, 2006
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Volume 5, Number 35; April 26, 2006 |
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62-year-old female found unresponsive.
Recommended reading:
The natural history of small renal masses. [Review]
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Patient: 62 year old female found unresponsive by family members; high calcium (17) led to workup for cancer; all tests including whole body CT were negative, PET scan eventually discovered renal cell carcinoma. |
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Session Handout:
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Clinical Question: 1) What are current aspects of renal cell carcinoma?
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Readings:
Link Directly to Fulltext Article at Publisher <12> Unique Identifier [PMID]: 16339096 Authors: Cohen HT. McGovern FJ. Institution: Renal and Hematology-Oncology Sections, Department of Medicine, Boston University School of Medicine, Evans Biomedical Research Center, Boston, MA 02118, USA. htcohen@bu.edu Title: Renal-cell carcinoma. [Review] [103 refs]
Source: New England Journal of Medicine. 353(23):2477-90, 2005 Dec 8. Publication Type: Journal Article. Review.
<2> Unique Identifier [PMID]: 16474735 Authors: Volpe A. Jewett MA. Institution: Division of Urology, Department of Surgical Oncology, Princess Margaret Hospital and the University Health Network, University of Toronto, Canada. Title: The natural history of small renal masses. [Review] [57 refs]
Source: Nature Clinical Practice Urology. 2(8):384-90, 2005 Aug. Abstract: The incidence of renal cell carcinoma is increasing, in part due to the growing use of cross-sectional imaging. Most renal tumors are now incidentally detected as small masses in asymptomatic patients. A minority of small renal masses, presumed to be renal cell carcinoma, grow significantly over time if managed conservatively, but the growth rate of the majority is slow or undetectable. In the absence of other prognostic factors, measurement of tumor growth rate can be helpful for initial conservative management of selected patients with small renal tumors. To date, there have been no reports of progression to metastatic disease occurring during active surveillance, but longer follow-up is needed to confirm this observation. The standard of care for small localized renal neoplasms is partial or radical nephrectomy. At the present time, active surveillance of small renal masses, with delayed therapy for patients whose disease progresses, is an experimental approach that can be considered for the elderly or patients with significant comorbidity. Renal core biopsy and fine-needle aspiration can provide essential information for treatment decision-making and should therefore be considered in the diagnostic work-up of all small renal masses. In future, the identification of prognostic indicators, with the use of new techniques including functional imaging and molecular or genomic characterization of tissue from needle biopsies, are expected to help clinicians differentiate between indolent and potentially aggressive small renal tumors. [References: 57] Publication Type: Journal Article. Review.
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Resident Report / Department of Medicine & Grady Branch Library Emory University School of Medicine 2005 Edition Participating Faculty: Carlos Del Rio MD / Joyce Doyle MD / Lorenzo Difrancesco MD / Erich Folch MD / Alicia Hidron MD
Contact:
Karl Woodworth
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