الفهرس 
Pathology of renal cell carcinomaOnly 14 pages are availabe for public view
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Abstract
Renal cell carcinoma (RCC) is the most common primary renal parenchymal malignancy. It is most common after the fifth decade of life and has a Male-female ratio of about 1.5:1. Treatment usually requires surgical resection.
The incidence of renal cell carcinoma continues to increase. Many cases are incidentally found at cross-sectional imaging examinations such as ultrasonography (US) and computed tomography (CT), with the current interest in screening CT, this trend is likely to continue.
Moreover, the incidence of RCC appears to be increasing independently of the use of cross-sectional imaging.
Conventional curative therapy for renal cell carcinoma has been open nephrectomy. However, several less invasive and/or nephron-sparing procedures have been developed as alternatives in selected patients. The newest of these therapeutic modalities involves percutaneous image-guided ablation with straight or expandable needle (Applicators that deposit energy). Radiofrequency ablation of small renal cell carcinoma is increasingly being performed in selected patients who are not ideal surgical candidates. Results are excellent for small exophytic tumors, but successful treatment is less likely as tumor size increases or the location becomes more central. The complication rate of radiofrequency ablation is favorable when compared to surgical techniques.
This study demonstrates that a substantial amount of experience supports the use of imaging-guided radiofrequency ablation in the treatment of primary RCC. Because surgical resection is a technique with low mortality and a proved success rate that is high, surgery must remain standard therapy for patients with potentially curable RCC.
However, some patients with early-stage RCC may not be surgical candidates. Imaging-guided radiofrequency ablation is an option for treatment in these patients. It appears this technique has a low complication rate, preserves renal function, is well tolerated by patients and in a high percentage of patients can eradicate small renal tumors.
In addition, imaging-guided radiofrequency ablation shows promise for the successful care of other patients with RCC. In particular, radiofrequency ablation has been used successfully in the treatment of refractory hematuria resulting from RCC, of local recurrence of RCC, and finally of isolated metastases from RCC. As with the treatment of primary RCC, the data remain limited for these applications; therefore, this technique should be reserved until standard therapies have been exhausted.
The use of radiofrequency ablation for the treatment of RCC is a very promising technique that should be considered a treatment option for patients with early-stage RCC who are poor surgical candidates.