Renal Malignancy in Adolescents and Young Adults in Ilorin.

Abstract

Introduction: Renal malignancy has been known to be mostly a disease of the middle-aged and elderly. In the last two decades, a rising incidence of these life- threatening diseases in the younger and more active population has been noted. There have been conflicting reports regarding whether these group of patients present with more advanced or poorly differentiated forms of renal cell carcinoma (RCC) as compared to what is found with the older population.We report our experience with young patients managed for renal cell carcinoma at theUniversity of Ilorin Teaching Hospital, their clinical presentation, challenges in management and outcome. Methods: We reviewed the records of all patients managed in the Urological Surgery unit for renal tumours between January, 2008 and August 2019; out of which relevant demographic and clinical data were obtained with the focus on patients between the ages of 14-40 years. Data obtained was analyzed. Results: A total of 12 patients were managed which constituted 30% of the renal tumour patients seen. Male to female ratio was 1:2.1. Right-sided lesions were predominant; a single case of bilateral RCC was managed. Stage IV disease was the commonest presentation such that treatment was mainly Open Radical Nephrectomy or Cyto-reductive surgery. Histologic types noted were papillary RCC, clear cell RCC and a single case of Squamous Cell carcinoma. Conclusion: Malignant renal tumours are more frequently diagnosed in the young population, with locally advanced or metastatic disease at time of presentation. Papillary RCC was most common in our review and prognosis was generally poor. There is need for a high index of suspicion for the diagnosis of renal tumours when reviewing this age group of patients.