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Pathologic Concordance Rates of Sporadic Synchronous Bilateral Renal Masses: A SEER analysis and Review of the Literature
Jason Rothman*1, Paul L. Crispen1, Yu-Ning Wong*2, Tahseen Al-Saleem2, Robert G. Uzzo2
1Temple University Hospital, Philadelphia, PA;2Fox Chase Cancer Center, Philadelphia, PA
Introduction: Bilateral sporadic enhancing renal masses account for up to 5% of newly diagnosed cases of renal cell carcinoma (RCC). The data regarding pathological concordance rates of malignant vs benign, histologic subtypes, and nuclear grade are limited.
Methods: An analysis of the Surveillance, Epidemiology, and End Results (SEER) database was performed to assess pathological concordance rates for bilateral sporadic renal tumors. Additionally, we collated data from a medline review (1966 to the present) and an assessment of our institutional tumor registry over a four year period regarding the pathology of bilateral sporadic RCC.
Results: A combined total of 436 patients had adequate pathologic data to be included in the series. Cancer concordance (bilateral malignancies) was noted in 402/420 (96%) of cases while benign concordance (bilateral benign solid renal masses) was noted in 16/35 (46%) of cases. Histologic concordance was seen in 92% (301/327) while nuclear grade was concordant in 84% (100/119) of available cases.
Conclusions:
A high rate of cancer concordance was noted in patients with sporadic bilateral synchronous renal masses. Thus, if cancer is identified ipsilaterally, the likelihood of finding RCC of any histologic type in the contralateral renal unit was 96%. However, an ipsilateral benign solid renal mass only predicted a benign contralateral lesion in 46% of cases. Nuclear grade was concordant 84% of the time. These data are important when counseling and managing patients with bilateral sporadic renal tumors.
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