Cellular Classification
Approximately 85% of renal cell cancers are adenocarcinomas, and most of those are
of proximal tubular origin. Most of the remainder are transitional cell
carcinomas of the renal pelvis. (Refer to the PDQ summary on Transitional Cell
Cancer of the Renal Pelvis and Ureter Treatment for more information.)
Adenocarcinomas may be separated into clear cell and granular cell carcinomas; however, the two cell types may occur together in some tumors. Some
investigators have found that granular cell tumors have a worse prognosis, but
this finding is not universal. Distinguishing between well-differentiated
renal adenocarcinomas and renal adenomas can be difficult. The diagnosis is
usually made arbitrarily on the basis of size of the mass, but size alone
should not influence the treatment approach, since metastases can occur with
lesions as small as 0.5 centimeter.
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