A.T. Cole

The Place of Bone Scan in the Diagnosis of Renal Cell Carcinoma

We herein review 12 cases of renal cell carcinoma evaluated by bone scan and skeletal survey. Comparison of these techniques revealed a high incidence of falsely negative results (42 per cent) when using skeletal survey alone. It is now our policy to include the bone scan in our initial evaluation of patients with renal cell carcinoma.

Cell-mediated immunity in renal cell carcinoma-preliminary report.

The microcytotoxicity test was used in 8 cases post-nephrectomy for renal cell carcinoma to stage the disease clinically and to evaluate immunologically. Half of the patients had stage IV disease and half were believed to be cured clinically. Cell-mediated immunity and serum blocking factors were found in all patients with known metastases. However, cellular immunity was not found in 3 of the 4 remaining patients and serum blocking factors were also not noted in the 2 clinically cured patients who were tested. These findings are compatible with the facts that cell-mediated immunity and serum blocking factors are found when there is a grossly discernible antigenic source, that serum blocking factors are lost in patients who are clinically free of tumor and that in some patients who are clinically cured with a possible total loss of antigenic presence there is a disappearance of significant cell-mediated immunity.

Aggressive surgery for renal cell carcinoma with vena cava tumor thrombus

Herein is presented what we believe to be the eighth case reported of renal cell carcinoma with caval tumor thrombus treated by radical excision with vena caval resection. A review of the literature reveals that although postoperative morbidity is minimal, only 1 patient survived more than two years. All patients with metastases at time of operation died within one year. It is our conclusion that the length and quality of survival anticipated must be carefully weighed before performing this major surgical procedure.

Antigenic cross reactivity between benign prostatic hyperplasia and adenocarcinoma of prostate

Tissue cultures were established from biopsy specimens of adenocarcinoma of the prostate (ACP) and benign prostatic hyperplasia (BPH). Generally, peripheral blood lymphocytes from BPH and ACP patients were cytotoxic to both ACP and BPH cells, but not normal fibroblasts nor cells cultured from other types of malignant tissue. Peripheral blood lymphocytes from normal control patients or from patients with other types of cancer were not cytotoxic to ACP- or BPH-derived cells. These findings are consistent with a cross reactive autoimmune response in ACP and BPH patients, directed against a common antigen(s) present on both ACP and BPH cells.

The role of ultrasonics in the evaluation of renal masses.

Analysis of our experience with echography in the evaluation of renal masses reveals an error rate of 31 per cent. Presently, this technique may be useful in directing the evaluation of a renal mass to either arteriography, if a tumor is suspected, or needle aspiration and renal cystogram, if a cyst is suspected. However, echography should not replace more definitive studies.

The Diagnosis of Renal Cell Carcinoma by use of a New Radiopharmaceutical: A Case Presentation

AbstractA case of a small, poorly vascularized renal cell carcinoma is reported because diagnosis was solely dependent upon renal scanning with a new agent, 99mtechnetium 2,3-dimercaptosuccinic acid. A description of this radiopharmaceutical and a discussion of possible application are included.

Pheochromocytoma: Recent experience with detection and management

Our experiences spanning a ten-year period have been reviewed with regard to pheochromocytoma. During this period 1,890 metanephrine excretion levels were performed; 91 of these were elevated. An over-all incidence of 1.9 per cent false positive studies was found. Factors contributing to the false positive studies are discussed. Fourteen patients had 15 pheochromocytomas resected. The presenting features, diagnosis, localization, preoperative and operative management, as well as the results are presented.

Experience with the Thoraco-Abdominal Incision for Nephroblastoma in Children Less than 3 Years Old

Our results with the routine use of a modified thoraco-abdominal incision in the treatment of patients with nephroblastoma are reported herein. We have used this incision successfully in 5 patients less than 3 years old and are impressed with the improved exposure. In our limited experience the thoracic extension has not adversely altered the operative or postoperative course.

Renal diversion with silicone circle catheters

Abstract At North Carolina Memorial Hospital, we have carried out renal diversion with silicone circle nephrostomy tubes in twenty-one patients. In our series there was one postoperative death and five major complications, two delayed hemorrhages and three catheter losses. A discussion of each is included. Over-all, our experience with this form of diversion has been gratifying. Tube changes are less frequent, and patient mobility and comfort are increased.