RESUMEN
This retrospective study aims to describe the characteristics of renal cell carcinoma (RCC) in Saudi Arabia, in terms of epidemiology, clinical presentation, tumor subtype, Fuhrman grade, tumor size and stage, and overall survival. A total of 431 adult patients with a histopathological diagnosis of RCC between 2015 and 2023 were included in the analysis. Most patients (72.4%) had clear cell tumors, followed by chromophobe (15.1%) and papillary (12.5%) subtypes. In males, papillary RCC (85.2%) was more common compared to clear cell (59.8%) and chromophobe (67.7%) subtypes. Significant differences were observed in median body mass index (BMI) across tumor subtypes, and papillary tumor patients exhibited the highest incidence of hematuria (33.3%) compared to other subtypes. The Fuhrman grade also varied significantly among RCC types. Survival times were found to be lower for patients with papillary tumors. No significant difference was observed based on patients' nationality. This study can inform clinical decision-making on patient prognosis and management as well as public health efforts aimed at reducing the alarming rise of RCC incidence.
RESUMEN
BACKGROUND: The incidence of renal cell carcinoma (RCC) in young adults has started to increase in recent years. OBJECTIVES: The objective of the study was to describe and compare the mode of presentation, incidence, risk factors, histopathological features, nephrectomy modalities used, and outcome in patients diagnosed with RCC below the age of 50. MATERIALS AND METHODS: A total of 139 confirmed RCC patients diagnosed below the age of 50 years who underwent nephrectomy from January 1990 to April 2019 were included in this retrospective review. We compared the characteristics of two age groups (≤40 years and 41-50 years) and evaluated incidentally discovered versus symptomatic tumors in patients below 50 years. RESULTS: Loin pain contributed to most symptomatic presentations in the older group (55%) (P = 0.014). Hypertension and diabetes were present in 24% of patients from 41 to 50 years of age versus 3.8% for hypertension and 5.7% for diabetes in the young group. (P = 0.001 and P = 0.004, respectively). Chromophobe was the second most common pathology (26.5%). Tumor size tended to be larger in the older group (P = 0.006). Fuhrman's grade was significantly lower in incidentally diagnosed patients (88.2%) (P = 0.006). The T stage was significantly lower in the incidental group (P = 0.005), but the mortality rate was higher in symptomatic patients (9.6%) (P = 0.013). CONCLUSION: RCC increases after the age of 40-50 years in the presence of other risk factors. Chromophobe represented almost a quarter percentage of the pathology, while partial nephrectomy yielded a better outcome.
RESUMEN
We report the case of a 15-year-old girl presenting with distended abdomen, left flank pain, and a history of weight loss. Computed tomography showed a large tumor involving the left kidney that was initially diagnosed as renal cell carcinoma. She underwent exploratory open laparotomy and left radical nephrectomy followed by chemotherapy and showed good response. Histology of the resected tumor revealed features of Ewing's sarcoma of the kidney which was confirmed by molecular studies. This disease is rare, particularly in the pediatric population, and this report will help better understand the potential disease course and response to treatment.
