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Advances in Urology
Volume 2008, Article ID 518091, 7 pages
Research Article

Multifocal Renal Cell Carcinoma: Clinicopathologic Features and Outcomes for Tumors 4 cm

1Departments of Urology, Mayo Clinic, Rochester, MN 55905, USA
2Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA

Received 27 February 2008; Accepted 20 March 2008

Academic Editor: José Rubio-Briones

Copyright © 2008 Paul L. Crispen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A significant increase in the incidental detection of small renal tumors has been observed with the routine use of cross-sectional abdominal imaging. However, the proportion of small renal tumors associated with multifocal RCC has yet to be established. Here then, we report our experience with the treatment of multifocal RCC in which the primary tumor was ≤4 cm. In our series of 1113 RCC patients, 5.4% (60/1113) had multifocal disease at the time of nephrectomy. Discordant histology was present in 17% (10/60) of patients with multifocal RCC. Nephron sparing surgery was utilized more frequently in patients with solitary tumors. Overall, cancer-specific, and distant metastasis-free survival appeared to be similar between multifocal and solitary tumors. These findings are consistent with previous series which evaluated multifocal RCC with tumors >4 cm. With the known incidence of multifocality RCC, careful inspection of the entire renal unit should be performed when performing nephron sparing surgery.