Thorbjörn Berge

Prostatic Carcinoma: An Autopsy Study

At routine examination the frequency of cancer of the prostate diagnosed or confirmed post mortem is about 20%. in a special investigation of 308 subjects the corresponding frequency was about 40%. the frequency of microscopic prostatic cancer increases with age and is about 44% in ages above 80 years. in the early stages the cancer grows mainly in the peripheral part of the prostae and no evidence of multifocal growth is available. the frequency of cancer in the perineural spaces and the extent of the growth in the prostate increase with age. Patients with cancer involvement of periurethral tissue in material obtained by electroresection or enucleation should be regarded as poor risks and as requiring treatment.

Unrecognized renal cell carcinoma. Clinical and diagnostic aspects.

In a series of 16294 autopsies 350 cases of renal cell carcinoma were found. Of these tumours 235, i.e. two thirds, were unrecognized during lifetime. Metastatic spread was revealed in 56 patients (24%) with unrecognized renal cell carcinoma and was the main cause of death of 49 patients (21%). In 67 patients (33%) a second malignant tumour was observed causing the death of 47 patients (20%). Most patients died with rather than from the renal malignancy. The symptomatology as to the renal malignancy was generally poor. Haematuria, palpable mass, polycythemia and fever of unknown origin were less common findings in the present series as compared with fatigue, loss of weight and symptoms from metastatic sites.

Unrecognized Renal Cell Carcinoma: Clinical and Pathological Aspects

In an autopsy series comprising 235 clinically unrecognized renal cell carcinoma metastatic spread was revealed in 24%. The number of metastasizing tumours increased significantly with the size of the primary tumour. Local aggressiveness of the primary tumour was more common for large tumours but was much more closely correlated to metastatic spread than to size. Tumours ingrowth in the renal vein was significantly commoner in metastasizing tumours as compared to non-metastasizing tumours. The study confirmed that an analysis as to local aggressiveness was prognostically valuable and might be useful to define the group of patients that may benefit from adjuvant therapy such as radiation therapy, chemotherapy or immunotherapy.

Unrecognized Renal Cell Carcinoma

In an autopsy series comprising 235 clinically unrecognized renal cell carcinoma metastatic spread was revealed in 24%. The number of metastasizing tumours increased significantly with the size of the primary tumour. Local aggressiveness of the primary tumour was more common for large tumours but was much more closely correlated to metastatic spread than to size. Tumour ingrowth in the renal vein was significantly commoner in metastasizing tumours as compared to non-metastasizing tumours. The study confirmed that an analysis as to local aggressiveness was prognostically valuable and might be useful to define the group of patients that may benefit from adjuvant therapy such as radiation therapy, chemotherapy or immunotherapy.