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[The role of CT scan in the diagnosis of renal cell carcinoma].

OBJECTIVES
To establish the role of CT scan as a reliable and effective method in the diagnosis of renal cell carcinoma (RCC) and to report the experience with this radiological test at the Manuel Fajardo Hospital.


METHODS
29 patients with the diagnosis of RCC who underwent CT scan during the period between January 1992 and December 2002 were evaluated. All patients were preoperatively classified as stages I to IV by CT scan. Tumor stage was confirmed by surgical findings and pathology report, and matched with preoperative CT scan evaluation in all cases.


RESULTS
29 patients with the diagnosis of RCC were treated, 65.5% were males and 34.5% females between 48 and 73 years of age. In 100% of the tumors were confirmed by ultrasound (US) and CT scan, and their limits were well defined. CT scan detected regional lymph nodes in 3.4% of the patients, distant lung metastases in two patients (6.8%) and bone metastases in one (3.4%). Preoperative study showed a tumor limited within the kidney in 72.3% of the patients, not exceeding Gerota's fascia in 17.2%, and extending outside Gerota's fascia in 10.3%. All patients underwent radical nephrectomy through an anterior approach and CT scan precision was confirmed, being quite similar to that of the surgical procedure.


CONCLUSIONS
CT scan with or without contrast is the most precise method of diagnostic confirmation and staging currently available, achieving 100 percent of the diagnosis in comparison with other diagnostic modalities.