[Diagnostic tumor resection in kidney tumors of unclear quality]. / Diagnostische Tumorresektion bei Nierentumoren unklarer Dignität.

ABSTRACT

From 1985 to June 1989 diagnostic tumour resections have been performed on 37 kidney tumours with unknown dignity following the preoperative imaging techniques. The kidney tumours were completely excised with about 1 cm of adjacent parenchyma outside the pseudocapsule during temporary ischemia. The tumours and biopsies from the resection margins were sent to quick frozen section. In case of benign histology or low grade clear cell carcinomas with exophytic growth and a size of less than 5 cm in diameter the operation was finished without removing of the kidney. In 21 patients with benign and 11/16 with malignant disease the kidneys could be preserved. In 5/16 patients the kidneys were removed after tumour resection and result of the quick frozen section. In our opinion the diagnostic kidney tumour resection in cases of kidney tumours with unknown dignity should be preferred to fine needle biopsies combining diagnostic and therapeutic proceeding in selected cases. On the other hand tumour resections without nephrectomy in patients with renal cell carcinoma and normal contralateral kidney should be done only in low grade tumours of small size.