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O carcinoma renal (CR) é uma neoplasia maligna originária do epitélio tubular renal. Este tipo de neoplasia é rara e acomete geralmente cães machos de meia idade. Os sinais clínicos são inespecíficos, podendo se assemelhar a outras doenças e isso acaba dificultando o diagnóstico que é realizado através dos exames de imagem (ultrassonografia e raio-X), da laparotomia exploratória e histopatológico para confirmação. Para o tratamento sugere-se a nefrectomia em casos de carcinoma renal unilateral e quimioterapia, porém não demonstram um aumento na sobrevida dos pacientes. O presente trabalho tem como objetivo relatar o caso de um cão de 8 anos, que foi atendido devido a sinais de cardiopatia e ao retorno apresentou sinais como êmese, anorexia e dor abdominal. Realizou-se exame de ultrassom, onde identificou-se uma estrutura de 7cm do lado esquerdo, realizou-se também exame de raio-X e posterior laparotomia exploratória, seguida de nefrectomia. O material coletado e enviado para histopatológico confirmou carcinoma renal bem diferenciado, padrão papilar. Após diagnóstico, o paciente foi encaminhado para um especialista em oncologia veterinária, que de acordo com os resultados dos exames realizados novamente, optou-se por não entrar com o tratamento quimioterápico.

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Se presentó el caso clínico de una mujer de 51 años de edad, fumadora inveterada, con antecedentes de anemia de varios años de evolución y trastornos de la personalidad, tratados en ocasiones con fenotiacinas, que comienza a referir desde hace un mes episodios recurrentes, caracterizados por trastornos del estado de ánimo con elementos melancólicos. Estos problemas fueron percibidos por sus compañeros de trabajo, pero sin darle la debida importancia hasta que, en una mañana, la paciente despierta con una hemiparesia izquierda. Se constató por tomografía axial computarizada una imagen de tumoración cerebral valorada por Neurocirugía, y se sometió a tratamiento conservador por parte de dicha especialidad con radiaciones. Mejorado el cuadro, la paciente fue dada de alta con seguimiento ambulatorio hasta que regresa al hospital dos meses después con fiebre de doce días de duración, vómitos en proyectil, cefalea y estado confusional agudo, decidiéndose su reingreso en el hospital militar de Matanzas. La paciente falleció y en la autopsia se constató un adenocarcinoma renal derecho, pobremente diferenciado con metástasis cerebrales múltiples.

Introduction: Renal cell carcinoma (RCC) is an aggressive disease worldwide. Objective: Study traditional prognostic factors associated with pathological reports and the novel markers survivin and B7-H1 by immunohistochemistry. Methods: In a reference hospital of Porto Alegre, Brazil, we conducted a cross-sectional study of RCC in patients who underwent radical nephrectomy between 2006 and 2009. We selected those who were diagnosed with the most common histologic subtypes: clear cell and papillary RCC. We retrospectively reviewed pathological data to determine traditional prognostic factors, like size, presence of coagulative necrosis, Fuhrman grade and tumor-node metastasis (TNM) system. Besides, we performed an immunohistochemistry (IHC) study with survivin and B7-H1. Results: Our sample had 98 cases, 90% of the cases were composed by clear cell histologic subtype, 73% were tumors classified as T1 and T2 in the TNM system, most were Fuhrman nuclear grade 2 or 3, and 70% were positive for necrosis. In relation to the new prognostic markers, we found 50 cases positive to survivin and 38 to B7-H1. In this investigation of traditional prognostic markers and new markers we observed that only necrosis was associated with positive results of biomarkers. < 0.001). Conclusion: This finding confirms previous studies that necrosis is an important factor to consider in the prognosis of RCC.

Mix renal carcinoma was noticed during the necropsic examination of a 14 year old mix breed female. Tumours were bilateral and metastasis was noticed in the spleen and myocard. Histological examination evidenced morphological aspects characteristic to the mixt renal carcinoma. Histological aspects described in this individual characterize renal cell carcinoma, also known as renal adenocarcinoma, hypernephroma or, in older literature, Grawitz tumour.

INTRODUÇÃO E OBJETIVO: O carcinoma de células renais (CCR) é umas das doenças urológicas de maior malignidade, correspondendo a 1%-3% de todos os tumores sólidos dos adultos. As les��es pré-malignas do CCR ainda não foram totalmente descritas. Achados de displasia intraepitelial tubular renal (DIETR) em áreas próximas ao tumor, livres de neoplasia, sugerem que esta alteração possa ser a precursora biológica de alguns tipos de CCR. O objetivo deste estudo é avaliar a possibilidade do uso de tissue microarray (TMA) no estudo da DIETR e do CCR e os parâmetros para sua utilização imuno-histoquímica (IHQ) utilizando os anticorpos anti-Ki-67 e p53 para confirmar a evidência de DIETR como precursora biológica do CCR. MATERIAL E MÉTODOS: O estudo foi realizado em 10 peças cirúrgicas de nefrectomias realizadas em pacientes com diagnóstico de CCR selecionadas no período de 2000 a 2005, em material arquivado no Instituto Nacional de Câncer (INCA). DISCUSSÃO: A utilização da técnica de TMA permite amostragem de várias áreas e realização da IHQ utilizando apenas duas lâminas, uma para cada marcador. Como não há na literatura descrição de utilização de TMA para estudo da DIETR, foi necessário inicialmente realizar estudo de validação para saber se haveria representatividade de lesões focais no TMA. RESULTADOS: A análise estatística não mostrou diferença entre a utilização de TMA com dois ou quatro cilindros de tecido ou o corte inteiro. CONCLUSÃO: O teste de validação de técnica artesanal de TMA autorizou o uso de dois cilindros de 1 mm² por caso.INTRODUCTION AND OBJECTIVE: Renal cell carcinoma is one of the most malignant urological diseases, corresponding to 1%-3% of solid tumors in adults. The finding of intratubular epithelial dysplasia (IED) next to tumor areas suggests that this can be the biological precursor of some types of renal cell carcinoma (RCC). The objective of this study is to evaluate the use of tissue microarray (TMA) to study IED and RCC by immunohistochemistry (IHC) with Ki-67 and p53 protein to confirm the evidence that IED is the biological precursor of RCC. MATERIAL AND METHOD: This study was performed in archival material from ten nephrectomy surgical specimens from Instituto Nacional de Câncer, between 2000 and 2005. DISCUSSION: TMA technique allows to sample and study several different areas from many patients in the same slide, using just one slide for each IHC marker. Once there was no previous study on IED by TMA, a validation test was needed first. RESULTS: There was no statistical difference between 2 or 4 tissue cores and the whole section analysis. CONCLUSION: TMA validation assay demonstrated that the use of two tissue cores with 1 mm² each was suitable to evaluate RCC and IED.

Resumen: El carcinoma renal de células claras es la variante más frecuente de carcinoma renal. En los últimos años, la atención se ha enfocado en la expresión de factores angiogénicos por estos tumores, lo que justificaría en parte su capacidad de crecer, invadir y diseminarse, determinando una peor evolución de aquellos pacientes con un perfil angiogénico desfavorable. Se estudiaron 83 piezas de nefrectomía con diagnóstico de carcinoma renal de células claras. Se recolectaron datos clínicos y patológicos. Los tumores fueron estudiados para evaluar la expresión inmunohistoquímica de los siguientes marcadores: VEGF-A, HIF-1?, CD34 y Ki67. Los resultados indicaron una relación lineal directa entre la expresión de estos cuatro marcadores. Además, la expresión de HIF-1? se encontraba directamente relacionada con el grado de Furhman, la invasión de la vena renal y el estadio tumoral. Asimismo, el índice de proliferación tumoral, evaluado con Ki67, se hallaba directamente relacionado con la presencia de necrosis, la invasión capsular y el estadio tumoral avanzado. Con respecto a la expresión de CD34, mientras mayor es la densidad vascular, menor es la necrosis tumoral y menor la sobrevida global. Los hallazgos resultan controvertidos en comparación con la literatura disponible. Se abriría, entonces, un escenario de investigación donde se destaca la importancia de generar estudios prospectivos y más estandarizados para determinar el rol que cumplen estos factores angiogénicos en la evolución tumoral y la posibilidad de estandarizar resultados que permitan un mejor estudio diagnóstico y pronóstico de estos tumores. Abstract Clear cell renal carcinoma is the most frequent type of renal carcinoma. Recently, attention has been focused in the expression of angiogenic factors by these tumors, which would justify in part their capacity to grow, invade and disseminate, stating a worse evolution of those patients with an unfavorable angiogenic profile. 83 samples of nephrectomy with a diagnosis of clear cell renal cell carcinoma were studied. Clinical and pathological data were collected. Tumors were studied to assess immunohistochemical expression of the following markers: VEGF-A, HIF-1?, CD34 and Ki67. Results indicated a direct linear relationship between expressions of these four markers. Besides, the expression of HIF-1? was directly related to Furhman grade, invasion of the renal vein and tumor stage. Likewise, tumor proliferation index, assessed with Ki67, was directly related to the presence of necrosis, capsular invasion and advanced tumor stage. Regarding the expression of CD34, vascular density was inversely related to tumor necrosis and overall survival. These findings are controversial compared with the available literature. Then, a research scenery would be open, where the importance of generating prospective and more standardized studies are highlighted to determine the role of these angiogenic factors in tumor evolution and prognostic evaluation of these tumors.

O adenocarcinoma do rim, ou hipernefroma, é a terceira neoplasia mais comum do trato geniturinário, sendo o de células claras o tipo principal, representando 60% dos casos, com pico de incidência entre 50 e 70 anos. A presença de metástase ao diagnóstico acomete em torno de 30% dos pacientes, tendo como principais sítios pulmões, ossos, pele, fígado e cérebro. Relatamos o caso de um paciente portador de carcinoma de células renais com metástase ao diagnóstico que, apesar de inserido na faixa etária predominante, tipo histológico mais frequente e quadro clínico característico, apresentava metástase a distância em local pouco observado na prática clínica. O paciente evoluiu para o óbito sem tempo hábil para o tratamento.Renal cell carcinoma or hypernephroma is the third most common neoplasia of the genitourinary tract. Its most common type, representing 60% of the cases, is the clear cell carcinoma, with an incidence peak between 50 and 70 years. Metastases are present at the time of diagnosis in approximately 30% of the patients, the major sites being lungs, bones, skin, liver, and brain. We report the case of a male patient with renal cell carcinoma, whose age, clinical findings, and tumor histological type matched with the most common ones for that pathology. Nevertheless, he already had distant metastasis in an uncommon site at the time of diagnosis. The patient died without undergoing specific treatment for renal cell carcinoma.

The article discusses the results of a case report which examined a 14-year-old mix breed female dog with mix renal cell carcinoma observed during the necroscopic examination. Results showed that the dog's spleen and myocard have bilateral and metastasis tumours. A histological test revealed morphological features indicating mix renal carcinoma also known as renal adenocarcinoma, hypernephroma or Grawitz tumour.

Regression of primary renal cell carcinoma (RCC) is a rare phenomenon and for several reasons many of the reported cases have been questioned. We present a case that can be considered a true spontaneous and complete regression of a primary RCC. A 79-year-old female underwent nephrectomy because a renal tumor. At the time of surgery image studies showed a small para-aortic lymph node. The tumor measured 3cm and was analyzed completely. Histology showed a fibro-inflammatory lesion with necrosis, foamy macrophages and inflammatory cells. No neoplastic cells were observed and the lesion was interpreted as a localized type of xanthogranulomatous pyelonephritis. One year later a CT control scan, showed that the para-aortic lymph node had increased in size to 4cm. Fine needle aspiration revealed features of clear RCC. Metastatic dissemination was limited so surgical removal of the para-aortic lymph node was performed and the cytologic diagnosis confirmed., (Copyright © 2019 Sociedad Española de Anatomía Patológica. Publicado por Elsevier España, S.L.U. All rights reserved.)

Purpose: Image-based morphometric scoring systems such as the RENAL and PADUA scores are useful to evaluate the complexity of partial nephrectomy for renal cell carcinoma (RCC). The main aim of this study was to develop a new imaging software to enable an automatic detection and a 3D visualization of RCC from CT angiography (CTA) and to address the feasibility to use it to evaluate the features of the RENAL and the PADUA scores., Methods: A training dataset of 210 patients CTA-scans manually segmented was used to train a deep learning algorithm to develop the automatic detection and 3D-visualization of RCC. A trained operator blindly assessed the RENAL and PADUA scores on a testing dataset of 41 CTA from patients with RCC using a commercialized semi-automatic software (ground truth) and the new automatic software. Concordance between the two methods was evaluated., Results: The median PADUA score was 9 (7-11) and the renal score was 8 (5.5-9). The automatic software enabled to automatically detect the tumoral kidney and provided a 3D-visualization in all cases, with a computational time less than 20 seconds. Concordances for staging the anatomical features of the RENAL scores were respectively: 87.8% for radius, 85.4% for exophytic rate, 82.9% for location to the polar lines and 92.7% for the antero-posterior location. For the PADUA scores, concordances were 90.2% for tumor size, 85.4% for exophytic rate, 87.8% for polar location and 100% for renal rim., Conclusion: By enabling an automatic 3D-visualization of tumoral kidney, this software could help to calculate morphometric scores, save time and improve reproducibility for clinicians., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Diagnosis and treatment of renal cell carcinoma with venous tumor thrombosis remains a challenge today, requiring multidisciplinary teams, mainly in tumor thrombus levels III-IV. Our objective is to present the various diagnostic techniques used and its controversies. A review of the most relevant related articles between January 2000 and August 2020 has been carried out in PubMed, EMBASE and Scielo. Continuous technological development has allowed progress in its detection, in the approximation of the histological subtype, and in the determination of tumor thrombus level. Regardless of the imaging technique used for its diagnosis (CT, MRI, TEE, ultrasound with contrast), the time elapsed until treatment is vitally important to reduce the risk of complications, some of them fatal, such as pulmonary thromboembolism., (Copyright © 2020 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Antecedentes: El carcinoma renal con diferenciación sarcomatoide confiere un pronóstico sombrío por su evolución metastásica; a mucosa oral corresponde menos del 1%., Caso Clínico: Mujer de 66 años, tumor dependiente de riñón izquierdo con reporte de patología de carcinoma renal de células claras patrón sarcomatoide, tumor gingival en maxilar izquierdo, biopsia con metástasis de células claras sarcomatoide. Recibió radioterapia local. Progresó con metástasis a sistema nervioso central, pulmonar, mediastinal y suprarrenal., Conclusiones: La presentación clínica de tumores renales en la mucosa oral es rara. La presencia de diferenciación sarcomatoide implica un reto terapéutico por la respuesta a las terapias sistémicas existentes. Los avances en fármacos con actividad inmunitaria podrían mejorar las tasas de respuesta., Background: The renal carcinoma with sarcomatoid differentiation confers a poor prognosis due to its metastatic evolution, less than 1% corresponds to oral mucosa., Case Report: 66 year old female, left kidney tumor, with pathology report clear cell renal carcinoma, with sarcomatoid pattern, gingival tumor in the left maxilla, biopsy with sarcomatoid metastases, received local radiotherapy. It progressed with metastases to the central nervous system, pulmonary, mediastinal and adrenal. ­., Conclusions: The clinical presentation of kidney tumors in oral mucosa is rare, the presence of sarcomatoid differentiation implies a therapeutic challenge due to the response to existing systemic therapies, advances in drugs with immunological activity could improve response rates., (Copyright: © 2020 Permanyer.)

Introduction and Objectives: The objective of this study is to evaluate overall survival (OS), cancer-specific survival (CSS), relapse-free survival, local and distant (LRFS and DRFS, respectively) rates in patients with pT3a renal cell carcinoma (RCC) considering the perirenal and/or sinus fat infiltration (FI) as prognostic factors., Materials and Methods: Retrospective cohort of patients with pT3a RCC who underwent radical or partial nephrectomy. The data were extracted from the LARCG (Latin American Renal Cancer Group) database. The demographic, clinical, pathological and surgical variables were evaluated. FI was divided into 4 groups (vein, perirenal, sinus and both fats infiltration). The Kaplan Meier and Cox regression curves were performed., Results: 293 patients were included in the study. The mean age was 61.4 years. The median follow-up was 21 months (r: 1-194). CSS, RFS, LRFS and DRFS estimated at 3 years in the group of both fats' infiltration were 53.1, 45.1, 58.7 and 51.6 months, respectively, and always statistically lower than the rest (P˂0.005). In the multivariate analysis, the infiltration of both fats significantly increased specific mortality, overall and local relapse with respect to vein infiltration (HR: 4.5, 2.42 and 8.08, respectively). The Fuhrman grade and renal pelvis infiltration were independent predictors of CSS and RFS., Conclusions: Infiltration of both fats increases the risk of overall and local relapse in pT3a RCC. In the same way, it is associated with a lower cancer-specific survival and should be considered as a factor of poor prognosis., (Copyright © 2019 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Partial nephrectomy (PN) is the standard treatment for small and localized kidney tumours (cT1). One of the controversial aspects regarding this technique is the management of affected/positive resection margins. We present the long-term oncological results in patients with PSM after PN managed conservatively., Material and Methods: There were 207 PN performed in our centre between 1990 and 2011. 17 patients presented PSM. 2 patients were excluded from the study due to completion nephrectomy afterwards. Follow-up was was done with abdominal contrast-enhanced computed tomography every 6 months for the first 2 years and subsequently, once a year. Cancer-specific survival and disease-free survival were calculated with the Kaplan-Meier method., Results: The median age was 62 years (RIQ: 55-71) and the mean tumour size was 34.8 (10-77) mm. Histopathological results were: 6 (40%) clear cell RCC, 4 (26.7%) papillary, 3 (20%) chromophobe and 2 (13.3%) oncocytic. The pathologic stages were: 11 (73.3%) pT1a, 1 (6.7%) pT1b and 3 (20%) pT3a. The median follow-up was 84 months (IQR 72-120). 2 patients had metastatic recurrence and this was the cause of death. The first one had recurrence at 112 months and the second one at 59. 5-year CSS and RFS were 87.5% and 93.3% respectively., Conclusions: In our experience, patients with PSM after PN can be managed conservatively with satisfactory long-term oncological outcomes., (Copyright © 2019 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To perform a literature review on the use of cavoscopy during surgery for renal cell carcinoma with vena cava thrombus (RCCVCT), according to the criteria of Evidence-Based Medicine., Material and Methods: We performed a Pubmed search for studies published with the following keywords: "renal tumor thrombus", "renal tumor cavoscopy" and "cystoscopy thrombus", without time limit and in English. With these criteria, 5 articles were identified with a total of 41 patients. All studies found are case series and expert opinions, so the degree of evidence in the use of cavoscopy in RCCVCT is low., Results: RCCVCT surgery is a complex technique, which can reach over 50% 5-year survival, when a complete oncological resection is achieved. One of the keys for surgical success is complete resection of tumor thrombus, having used different techniques for its verification. One of them is cavoscopy, which consists on the introduction of a flexible cystoscope through the cavotomy incision after thrombectomy, checking the lumen of the vena cava with saline serum irrigation. In two series of clinical cases, cavoscopy detected thrombus persistence in 22% and 43% of patients respectively, allowing resection. The entire resected thrombus showed malignancy in several cases., Conclusion: Cavoscopy is a technique that improves detection of tumor remnants after thrombectomy in comparison to indirect review methods. Although oncological impact of caval thrombus is controversial, the use of cavoscopy allows a more complete resection of the thrombus, and it may offer a possible increase in the recurrence-free survival of these patients.

Context and Objective: There have been significant advances in the knowledge of renal carcinogenesis n the last years. Nowadays, renal tumors are classified according to their genetic profile and specific treatments based on the identification of therapeutic targets have also been developed. However, no prognostic markers have yet been identified. The aim of this review is to analyse literature that has evaluated the expression of the STAT3 protein as a molecular marker in clear cell renal carcinoma (ccRCC)., Evidence Acquisition: In January 2018 a systematic review was conducted in Pubmed, Cochrane library and Sciencedirect databases, from papers published from 1990. Search terms were"renal cell carcinoma"and"STAT3"or"STAT-3"and"prognostic factor. Following the principles of the PRISMA declaration and the PICO selection strategy, original articles with series of patients diagnosed with localized or metastatic ccRCC, and where the activity of STAT3 is analysed as a prognostic marker, were selected. A total of 132 publications were identified, of which 10 were finally revised, for they met the inclusion criteria., Evidence Synthesis: STAT3 activation (phosphorylation) through Ser727 is important during ccRCC development and progression. PSTAT3 expression seems to be a prognostic marker and an antiangiogenic-resistance marker in metastatic patients. There is little evidence as prognostic marker in patients with localized disease., Conclusions: STAT3 (Ser 727) expression in the nucleus of the ccRCC cells can be a prognostic marker and an antiangiogenic-resistance marker. Current scientific evidence is limited and more studies are needed to demonstrate its usefulness., (Copyright © 2018 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The objective of this study was to determine the reproducibility in a murine model of renal tumours of various histological strains that could be useful for investigating the response to target drugs., Material and Methods: Development and analysis of the "in vivo" model: tumour xenograft of renal cell carcinomas with Balb/c nude athymic mice. Nontumourous human renal tissue was implanted in the interscapular region of 5 mice, chromophobe renal cell carcinoma was implanted in 5 mice (which, after checking its growth, was prepared for implantation in another 10 mice) and Fuhrman grade 2 clear cell renal cell carcinoma (CCRCC) was implanted in 5 mice (which was also subsequently implanted in 10 mice). We monitored the tumour size, onset of metastases and increase in size and number of tumours. When the size had reached a point greater than or equal to locally advanced or metastatic carcinoma, the animals were euthanised for a pathological and immunohistochemical study and a second phase of implantation., Results: The subcutaneous xenograft of the healthy tissue did not grow. The animals were euthanised at 6 months and no renal tissue was found. The chromophobe renal cell carcinoma cells grew in the initial phase (100%); however, in the second phase, we observed a chronic lymphomonocyte inflammatory reaction and a foreign body reaction. The CCRCC grew at 5-8 months both in the first and second phase (100%), maintaining the tumour type and grade., Conclusions: The model with athymic Balb/c nude mice is useful for reproducing CCRCC, with the same histological characteristics and aggressiveness as native human tumours, promoting the development of the second experimental phase., (Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Context and Objectives: The natural history of renal cell carcinoma is heterogeneous. Some scenarios can be found in terms of clinical presentation, clinical evolution or type of recurrence (local/metastatic). The aim of this publication is to analyze the most important prognostic factors published in the literature., Evidence Acquisition: A literature review ob published papers was performed using the Pubmed, from first Motzer's classification published in 1999 to 2015, according to PRISMA declaration. Search was done using the following keywords: kidney neoplasm, kidney cancer, renal cell carcinoma, prognostic factors, mortality, survival and disease progression. Papers were classified according to level of evidence, the number of patients included and the type of study performed., Evidence Synthesis: The evolution in the knowledge of molecular pathways related to renal oncogenesis and the new targeted therapies has left to remain obsolete the old prognostic models. It's necessary to perform a continuous review to actualize nomograms and to adapt them to the new scenarios., Conclusions: Is necessary to perform a proper external validation of existing prognostic factors using prospective and multicentric studies to add them into the daily urologist clinical practice., (Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: De novo renal carcinoma in kidney transplants is an uncommon but not exceptional condition and is of significant importance due to the potential for recipient mortality and graft loss. The aim of our study was to determine the management and outcome of these tumors in our Kidney Transplantation Unit., Material and Methods: We analyzed cases of de novo kidney tumors among patients who underwent transplantation in the last 17 years in our Kidney Transplantation Unit. We detected 3 cases of clear cell carcinoma and 1 case of papillary carcinoma on the graft. We conducted follow-up on the tumor and renal function and analyzed patient responses to changes in immunosuppression., Results: Tumorectomy was performed in all cases, and subsequent transplantectomy was required for patients with papillary carcinoma. None of the patients had relevant surgical complications. We also changed the patients' regimen to a proliferation signal inhibitor or mTOR inhibitor and completely withdrew all anticalcineurin agents. With a mean follow-up of 43.5 months (15-61), the 3 patients with clear cell carcinoma survived with good graft function and with no evidence of tumor recurrence. The patient with papillary carcinoma underwent follow-up at another hospital center., Conclusions: Conservative surgery along with conversion to a proliferation signal inhibitor appears to be a safe option for treating primary tumors in kidney grafts and offers good oncological and renal function results in the short and medium term., (Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Case Report: We present the case of a 56 year-old male with a pulsating lesion in the temporal region of the left orbit as presenting sign of a renal cell carcinoma. A review is also presented of all cases of orbital metastases diagnosed in our hospital between 1957 and 2012., Discussion: Carcinoma is the most common malignancy involving the kidney but, only rarely does it metastasize to the orbit. As these tumors can be confused with other amelanotic or vascular tumors, a high index of suspicion is required for early detection and management of the primary tumor., (Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.)

Objective: To evaluate our long-term experience with laparoscopic partial nephrectomy (LPN) and to review the literature., Material and Methods: We performed a retrospective chart review, evaluating 227 consecutives laparoscopic partial nephrectomies performed between June 1995 and June 2010. Perioperative were recorded along with clinical a oncological outcomes., Results: Mean age was 56.4 years (18-87) and clinical stages were T1a, T1b and T2 in 90.74% (206/227), 7.48% (17/227) and 1.76% (4/227), respectively. Median blood loss was 250 mL (10-1800). The mean operative time was 108.42 minutes (30-240) and median warm ischemia time was 25 minutes (10-60). The intraoperative complication rate was 2.64% (6/227), 5 (2.2%) secondary to bleeding. The postoperative complication rate was 5.72% (13/227) and bleeding is also the most frequent in 3% (7/227) of the cases. According to the Clavien classification, 1.32% (3/227), 0.88% (2/227) and 3.52% (8/227) were grade I, II and IIIb, respectively. The mean hospital stay was 3.66 days (1-12). Clear cell carcinoma was the most common histological finding in 74.6% (150 patients). TNM clasification was T1a, T1b y T2 in 90.74% (206/227), 7.48% (17/227) and 1,76% (4/227), respectively. No conversion or mortality was reported. Positive surgical margins were found in 4 patients (2.7%), with no local recurrence after long-term follow-up. At a mean follow up of 27 months, one patient had port site and peritoneal recurrence., Conclusion: Laparoscopic partial nephrectomy is a safe and viable alternative to open partial nephrectomy, providing equivalent oncologic outcomes and comparable morbidity to the traditional approach in experienced centers., (Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.)

Objective: To assess microvascular tumor invasion and other clinical and histological parameters as potential prognostic factors in surgically treated renal cell carcinoma., Materials and Methods: Surgical specimens from 238 consecutive patients who underwent radical or partial surgery between 1990 and 2006 were retrospectively evaluated. The series included clinically localized or metastatic renal cell carcinoma (pT1-4; N0-1; M0-1). Disease-free and cancer-specific survival assessments were the end points with median follow-up of 75 months (range 1-189 months). Variables studied included: age, sex, tumor size, TNM 2010 classification, Fuhrman grade, histological subtype and microvascular tumor invasion., Results: Microvascular tumor invasion was observed in 79 patients (33,2%) and was significantly associated with age (P=.010), tumor size (P=.000), Fuhrman grade (P=.000), pT stage 2010 (P=.000),N stage 2010 (P=.000) and M stage 2010 (P=.000). Multivariate analyses determined that sex, Fuhrman grade, pT stage 2010 and histological subtipe were independent prognostic factors of disease-free survival, while sex, Fuhrman grade, pT stage 2010, M stage 2010, histological subtype and microvascular invasion were prognostic factors for cancer-specific survival., Conclusions: Our study shows that microvascular tumor invasion is an independent prognostic factor for cancer-specific survival in surgically treated patients with renal cell carcinoma., (Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.)