The Management of Renal Tumors, Including Cysts

Malignant growths of the parenchyma of the kidney may be classified broadly, for purposes of management, as hypernephromas and carcinomas; they are seldom distinguishable from each other before operation. Hypernephromas have an irregular cellular structure and are radiosensitive, while carcinomas have a fairly typical microscopic arrangement and are apt to be radioresistant. Apart from their histologic structure, sarcomas and teratomas have practically the same characteristics as hypernephromas. Because of diagnostic difficulties, neoplasms of the kidney pelvis must be included here; they are squamous cell growths, similar in structure to those occurring in the bladder, are not sensitive to the roentgen ray and have just as indefinite an evolution as do vesical tumors. Long and varied experience has shown that the only curative treatment for malignant neoplasms is removal of the affected kidney and its contained or attached growth, together with such neighboring tissues as may have been infiltrated by it.