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Around this was a thin rim of viable tumour cells surrounded by a thick fibrous capsule.The tumours required extensive tissue sampling, sometimes with immunohistochemistry for cytokeratins, to make a confident diagnosis of malignancy.

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The clinical follow up data of these patients were then obtained.Three cases were rejected because two were diagnosed at necropsy, and a third was the result of renal arterial embolisation.Results: Twenty of the 34 cases showed 95% necrosis) is rare in RCC, accounting for only 1.6% of those diagnosed during eight years in this unselected hospital series.The pathology reports of all 253 RCCs diagnosed between 19 at the department of pathology at Queen Alexandra Hospital, Portsmouth, UK, were reviewed after they were identified by searching the laboratory computer database using a SNOMED search for all RCCs.We identified 37 tumours where the pathologist had commented that there was evidence of either macroscopic or microscopic necrosis at the time of originally reporting the case.

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