Hypernephroma in the Solitary Kidney: Experience with 20 Cases and Review of the Literature

Abstract

Twenty patients with renal cell carcinoma in anatomically or functionally solitary kidneys were treated and followed for up to 18 yr. Factors pertinent to management and survival of these patients and 66 other well documented similar patients reported in the literature are analyzed. Most of the patients were unusually young and a significant number had nephrectomy for contralateral renal cell carcinoma. Survival was closely related to the earlier presence of malignant disease in the other kidney, duration of the interval between detection of the 2 neoplasms and the stage of the lesion in the solitary kidney. Partial nephrectomy was the most successful treatment. The mean survival in the Mayo Clinic series was 6 yr for patients still alive and 2.4 yr for those dead at the time of this analysis. Results in this and other series emphasize the importance of thorough long-term followup after nephrectomy for hypernephroma and aggressive therapy when the remaining kidney becomes involved. It is foolish to abandon hope because there is a malignant tumor in a solitary kidney.