Oncocitoma Renale: Una Possibilità per una Terapia Conservativa

Abstract

Renal oncocytoma cells differ from those of other renal carcinomas. They arise from the intercalated cells of the collecting tubules. Originally it was considered a benign neoplasm, but it is now believed that it can have a limited but real malignant or metastatic potentiality. Between 1988 and 1992, 53 néphrectomies were performed in our department of urology for renal parenchymal carcinomas. 5 cases were diagnosed as oncocytomas (9.4%). 4 of these occurred in men (80%) and 1 in a woman (20%). The age of the patients is between 45 and 70 years old, with an average age of 60.6 years. At present the therapeutic approach of renal oncocytoma is no different from that of renal cell carcinoma. Standard therapy is radical nephrectomy. In the presence of small and peripheral well-encapsulated renal tumours the techniques of nephron sparing are preferred. In fact, as referred by Steinbach, with conservative surgery, good results were obtained even after 5 years (from 84% to 96%), not only in the imperative indication (tumours found in an anatomically or functionally solitary kidney or bilateral renal tumours) but even in the elective indication (patients with a small solitary mass lesion in the kidney and a normal contralateral kidney).