I had a kidney tumor removed (partial nephrectomy) – was clear cell renal carcinoma limited to the kidney – grade 1 (2.4cm) but stage 4 (WHO/ISUP 4) with clean margins. Pathology said it had sarcomatoid differentiation (95% sarcomatoid element) and extensive necrosis, extreme nuclear pleomorphism, multinucleate giant cells and /or rhabdoid sarcomatoid differentiation. Adrenal gland not identified and regional lymph noded pnx (could not be assessed. Pt1a grade. 5 questions: 1. Because it was grade 4 my doctor is recommending full removal of the kidney in 6 weeks. Is that the recommended course of action – is it likely that recurrence would be at that kidney again and removal lessens my chance of recurrence? 2. Should I have a PET scan, brain scan, bone scan, etc now since it was grade 4? They are saying just a chest CT is required now? 3. Is my likelihood of recurrence or distant metastes high because it was grade 4 even though it was very small stage 1a? Lots of conflicting information? 4. If the tumor was removed am I considered disease free and now just need aggressive regular surveillance? 5. How would I know if there was microvascular invasion and is the necrosis and sarcomatoid indicators of a recurrance? I’m quite scared so thank you so much for answering my questions!

The questions that you ask are surgical questions and must be asked of a urologist.  I am a nephrologist and do not have any surgical expertise in regards to kidney cancers.  If you have concerns about the opinions of your current urologist, I suggest that you get a second opinion.  I am not able to provide any surgical advice about treatment of kidney cancer.



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