Renal and Adrenal Tumors

The present volume constitutes an attempt to compile contem­ porary features of diagnosis and treatment of renal and adrenal tumors. A thorough survey of the field is ensured by the authors' considerable scientific experience. Tumors of the kidneys and the adrenal glands are being diagnosed and treated by physicians of different medical disciplines. For both types of tumor, the pathologic cellular substrate is of crucial importance in diagnosis and therapy. In recent years significant diagnostic advances have been made, ranging from angiography through ultrasonography and computer tomography to immunology. New impulses in oncologic therapy have occurred in surgery, radiation therapy, and tumor emboliza­ tion. A further important topic is renal tumors in infants. Such tumors involve special aspects of both diagnosis and therapy and also have a distinctive prognosis. We are indebted both to Springer-Verlag, who supported us in our intention to write this book, and to our colleagues, whose help is greatly appreciated. For the authors: E. LOHR Essen/Heidelberg, September 1979 Contents (Chapters marked with an asterisk have been translated by H.-U. Eickenberg) Pathology of Renal and Adrenal Neoplasms L.-D. Leder, H.J. Richter, and Chr. Stambolis ...... . 1. Tumors and Tumor-Like Lesions of the Kidney in the Adult 1.1. General Remarks . 1.2. Heterotopic Tissue . . . . l.2.l. Adrenal Tissue . . . . . .

Pathology of Renal and Adrenal Neoplasms.- 1. Tumors and Tumor-Like Lesions of the Kidney in the Adult.- 2. Renal Neoplasias of Infancy and Childhood.- 3. Tumors of the Renal Pelvis.- 4. Tumors of the Adrenal.- Kidney Tumor Vascularization: Morphology and Angiogenesis, a Microangiographic Experimental Study.- 1. Introduction.- 2. Macro- and Microangiographic Methods.- 3. Experimental Kidney Tumors.- 4. Microangiographic Study of Experimental Tumors.- Angiography in Renal Tumors: Indications and Technique.- 1. Urography: No Abnormality.- 2. Urography: Cystic Lesion.- 3. Urography: Solid Tumor.- 4. Urography: Tumor?.- 5. Angiographic Techniques.- 6. Summary.- Pharmacoangiography of the Kidney.- Value of Computerized Tomography and Ultrasonography in the Diagnosis of Renal and Adrenal Space-Occupying Lesions.- 1. Computerized Tomographic Diagnosis of Renal Space-Occupying Lesions.- 2. Sonographic Diagnosis of Renal Space-Occupying Lesions.- 3. Value of Sonography and CT in the Diagnosis of Suprarenal Space-Occupying Lesions.- Radiologic Evaluation of Bilateral Space-Occupying Lesions of the Kidney: a Multifaceted Approach.- 1. Introduction.- 2. Pathologic Anatomy.- 3. Advances in Diagnostic Radiology.- 4. Advances in Therapy.- 5. Material and Results.- 6. Conclusions.- Radiologic Diagnosis of Renal Mass Lesions: a Rational Approach.- 1. Urography.- 2. Ultrasonography.- 3. Retrograde Pyelography.- 4. Angiography.- 5. Computerized Tomography.- 6. Current Diagnostic Approach.- Angiographic Diagnosis of Poorly Vascularized Renal Tumors with Emphasis on Electronic Harmonization and Magnification.- 1. Introduction.- 2. Methods and Patients.- 3. Results.- 4. Discussion.- Roentgen-Guided Percutaneous Punctures of the Kidney.- 1. History.- 2. Renal Cyst Puncture and Aspiration.- 3.Translumbar Antegrade Pyelography.- Ultrasound Diagnosis of Renal and Pararenal Tumors.- 1. Introduction.- 2. Method.- 3. Anatomy of the Normal Kidney.- 4. The Non-normal Kidney.- 5. Diagnostic Accuracy and Methodologic Limitations.- 6. Diagnostic Procedure.- 7. Summary.- Diagnosis of Renal and Adrenal Tumors in Nuclear Medicine.- 1. Nuclear Medicine in the Diagnosis of Renal Tumor.- 2. Diagnostic Methods of the Adrenal Glands with Nuclear Medicine.- 3. Results.- 4. Summary.- Retrospective and Prospective Clinical Aspects in Hypernephroma.- 1. Introduction.- 2. Etiology.- 3. Epidemiology.- 4. Symptomatology and Clinical Findings.- 5. Diagnosis.- 6. Staging.- 7. Therapy.- 8. Prognosis.- 9. Final Remarks.- Nonoperative Treatment of Hypernephroma.- 1. General Remarks.- 2. Radiotherapy.- 3. Medical Therapy.- Balloon Occlusion and Embolization of the Renal Arteries: Indications and Clinical Results.- 1. Introduction.- 2. Material and Methods.- 3. Results.- 4. Discussion.- 5. Summary.- Transcatheter Embolization of the Kidney: Experimental and Clinical Data.- 1. Introduction.- 2. Technique.- 3. Results.- 4. Discussion.- 5. Summary.- Balloon Occlusion of the Renal Artery and Its Clinical Application.- 1. Introduction.- 2. Technique.- 3. Indications for Use.- 4. Complications.- Immunologic Aspects of Malignant Renal Disease.- 1. General Immunologic Considerations of Tumors.- 2. Humoral Immunity in Renal Cell Carcinoma.- 3. Cell-Mediated Immunity in Renal Cell Carcinoma.- 4. Current Clinical Application of Tumor Immunology.- 5. Prognostic Value of Immunological Tests.- 6. Immunotherapy.- Preoperative Localization of Pheochromocytoma.- 1. Introduction.- 2. Radiologic Diagnosis.- 3. Findings.- 4. Discussion and Suggestions for Technique.- 5. Complications and Pretreatment.- 6. Summary.- Computed Tomography of the Adrenal Glands.- 1. Introduction.- 2. Computed Tomographic Technique.- 3. Normal Adrenal Glands.- 4. Computed Tomography in Adrenal Disease.- 5. Miscellaneous Adrenal Gland Abnormalities.- 6. Summary.- Prenatal Wilms' Tumor.- Prenatally Developed Neuroblastoma.- Nephroblastoma.- 1. Introduction.- 2. Etiology.- 3. Pathologic Anatomy.- 4. Immunology.- 5. Biochemistry.- 6. Clinical Aspects.- 7. Metastases.- 8. X-ray Findings.- 9. Differential Diagnosis.- 10. Diagnosis.- 11. Therapy.- 12. Prognosis.- Nephroblastoma in Childhood (Wilms' Tumor): Clinical Signs and Operative Therapy.- 1. Introduction.- 2. Pathologic Anatomy.- 3. Etiology.- 4. Incidence.- 5. Clinical Manifestations.- 6. Diagnosis.- 7. Therapy.- Nonsurgical Management of Wilms' Tumor.- 1. Introduction.- 2. Prognostic Factors Influencing Treatment Plan.- 3. Postoperative Chemotherapy.- 4. Postoperative Radiotherapy.- 5. Planning Patient Treatment.- 6. Treatment of Bilateral Wilms' Tumor.- 7. Treatment of Metastases.- 8. Outlook for Further Development in the Treatment of Wilms' Tumor.- References.