Histopathology of surgically treated renal tumours in young adults: a developing country perspective.

Background: There is no data on the histopathological characteristics of renal tumours in young adults in Pakistan.

Materials And Methods: We retrospectively analysed 133 young adults (age: 16 to ≤40 years) who underwent nephrectomy for suspected renal cancer from 1994 till July 2010. The demographical and pathological parameters were determined from original surgical biopsy reports and case files, and analysed.

Results: The mean age of patients was 33.3 ± 6.2 years. Overall, 121 (88.9%) renal tumours were malignant, and 15 (11%) benign. Among malignant tumours, renal cell carcinoma (RCC) was predominant (100/121; 82.6%). The subtypes of RCC included: clear cell RCC, 84 (84%); papillary RCC, 11 (11%), chromophobe RCC, 3 (3%) and sarcomatoid RCC, 2 (2%). Other malignant tumours included: transitional cell carcinoma (9/121; 7.4%), primitive neuroectodermal tumour (5/121; 4.1%), synovial sarcoma (2/121; 1.6%), Non-Hodgkin's lymphoma (2/121; 1.6%), leiomyosarcoma (1/121; 0.8%), malignant fibrous histiocytoma (1/121; 0.8%) and squamous cell carcinoma (1/121; 0.8%). Among benign tumours, there were 11 cases of angiomyolipoma (11/15; 73.3%), three cases of oncocytoma (3/15; 20%) and one case of schwannoma (1/15; 6.6%). Almost two-third (62.7%) patients had stage I/II tumours, 22 (18.1%) stage III and 23 (19%) stage IV disease at the time of surgery.

Conclusion: A wide variety of renal tumours is documented in young adults with large size of the tumours and late presentation in our population.