Unrecognized renal cell carcinoma. Clinical and pathological aspects.

In an autopsy series comprising 235 clinically unrecognized renal cell carcinoma metastatic spread was revealed in 24%. The number of metastasizing tumours increased significantly with the size of the primary tumour. Local aggressiveness of the primary tumour was more common for large tumours but was much more closely correlated to metastatic spread than to size. Tumours ingrowth in the renal vein was significantly commoner in metastasizing tumours as compared to non-metastasizing tumours. The study confirmed that an analysis as to local aggressiveness was prognostically valuable and might be useful to define the group of patients that may benefit from adjuvant therapy such as radiation therapy, chemotherapy or immunotherapy.