KIDNEY CANCER
Kidney cancer arise from the cortex or pelvis. These may be benign or malignant. Malignant
tumors are common and the most common is renal cell carcinoma.
It accounts 90% of kidney cancers. Renal cell cancer is a kidney cancer that originates in the
lining of the proximal convoluted tubule. Renal cell carcinoma is also known as
hypernephroma, Grawitz tumor, renal adenocarcinoma. It is more prevalent in adult life after
40 years.
1. Renal tumor originates in kidneys in two locations, i.e. renal tubules and renal pelvis.
2. Renal tubules tumor is renal cell carcinoma and clear cell adenocarcinoma.
3. Renal pelvis tumor is transitional cell carcinoma.
Other Types of Renal Tumors
1. Nephroblastoma: It is also known as Wilm's tumor. It is rare in adults.
2. Sarcoma: It is infrequent, arises in the renal capsule.
3. Epithelial tumors: It is a tumor arises in the renal pelvis and includes three types of tissues:
a. Transitional cell
b. Squamous cell
c. C. Adenocarcinoma
Stages
Stage I
Confined to kidney (renal) capsule.
Stage Il
Invasion through the capsule in local perinephric fat but has no metastasis.
Stage III
Extends into ipsilateral renal vein, regional lymph node, or inferior vena cava involvement.
Stage IV
Locally invasive or distant metastasis to other parts of the body.
Etiology and Risk Factors
The etiology of renal tumors is unknown. The risk factors are:
1. Renal cell carcinoma arises from proximal convoluted tubule.
2. Cigarette smoking and tobacco consumption.
3. Obesity particularly in women.
4. Hypertension
5. Occupational exposure to certain chemicals, such as tríchloroethylene, asbestos,
cadmium, lead, chlorinated solvents, petrochemicals and Polycyclic Aromatic
Hydrocarbon (PAH).
6. Long term use of Non-steroidal Anti-inflammatory Drugs (NSAIDs).
7. Women who have had a hysterectomy are at more than double the risk of developing
renal cell carcinoma than those who have not.
8. Hereditary factors have a minor impact on individual susceptibility with immediate
relatives of people with RCC.
9. Race: Renal cell carcinoma is more common in Northern European ancestry and North
Americans than Asian or African descent.
1
, Pathophysiology
Due to any risk factors
Tumor growth begins in the renal cortex-
tubular epithelium, anywhere in kidney
with clearly defined margin and continue
for sometime
Clinically manifestation of flank pain,
hematuria and abdominal mass
Hormones producing
paraneoplastic syndrome Compressing adjacent renal parenchyma and
surrounds blood vessels and constrict them
Hypercalcemia, hypertension, Renal vein, Lungs, bones, Lymph nodes,
hyperglycemia liver, Brain
Clinical Manifestations Continue
1. In early stage, renal cancer is asymptomatic.
SpreadsClassical triad
to • Lungs, of renal
bones cancer
•Lymph in advance
nodes,
stage are hematuria, palpable flank mass and
liver flank pain.
2. Routine physical examination revealsBrain
a palpable abdominal mass.
3. Painless hematuria (gross and intermittent).
4. Flank pain: It is on the side of the body between the hip and ribs. May be dull pain in
Continue
the back from pressure produced by compression.
Spreads to • Lungs, bones •Lymph nodes,
5. Colicky pain: It occurs, if clot or mass of tumor cells passes down the ureter.
liver
6. Renal cell carcinomas secrete parathyroid
Brainand erythropoietin that leads to manifestation
of hypocalcemia and erythrocytosis.
7. Anemia
8. Hypertension resulting from secretion of renin by the tumor.
Diagnostic Evaluation
1. Urine analysis: Urinalysis can test for sugar, protein and bacteria which can also serve
as indicators for cancer.
• A complete blood cell count can also provide additional information regarding the
severity and spreading of the cancer.
2. Intravenous pyelography or ultrasound: They are used to determine size of tumor.
UltrasOtund differentiates renal cyst from solid lesions.
3. Ultrasound, CT scan and MRI: It is used to delineate tumors. MRI is used to identifty
thrombus that may have formed in renal vein.
4. Blood test: It is done to check complete blood count with SMA-12 and liver function
test.
2
Kidney cancer arise from the cortex or pelvis. These may be benign or malignant. Malignant
tumors are common and the most common is renal cell carcinoma.
It accounts 90% of kidney cancers. Renal cell cancer is a kidney cancer that originates in the
lining of the proximal convoluted tubule. Renal cell carcinoma is also known as
hypernephroma, Grawitz tumor, renal adenocarcinoma. It is more prevalent in adult life after
40 years.
1. Renal tumor originates in kidneys in two locations, i.e. renal tubules and renal pelvis.
2. Renal tubules tumor is renal cell carcinoma and clear cell adenocarcinoma.
3. Renal pelvis tumor is transitional cell carcinoma.
Other Types of Renal Tumors
1. Nephroblastoma: It is also known as Wilm's tumor. It is rare in adults.
2. Sarcoma: It is infrequent, arises in the renal capsule.
3. Epithelial tumors: It is a tumor arises in the renal pelvis and includes three types of tissues:
a. Transitional cell
b. Squamous cell
c. C. Adenocarcinoma
Stages
Stage I
Confined to kidney (renal) capsule.
Stage Il
Invasion through the capsule in local perinephric fat but has no metastasis.
Stage III
Extends into ipsilateral renal vein, regional lymph node, or inferior vena cava involvement.
Stage IV
Locally invasive or distant metastasis to other parts of the body.
Etiology and Risk Factors
The etiology of renal tumors is unknown. The risk factors are:
1. Renal cell carcinoma arises from proximal convoluted tubule.
2. Cigarette smoking and tobacco consumption.
3. Obesity particularly in women.
4. Hypertension
5. Occupational exposure to certain chemicals, such as tríchloroethylene, asbestos,
cadmium, lead, chlorinated solvents, petrochemicals and Polycyclic Aromatic
Hydrocarbon (PAH).
6. Long term use of Non-steroidal Anti-inflammatory Drugs (NSAIDs).
7. Women who have had a hysterectomy are at more than double the risk of developing
renal cell carcinoma than those who have not.
8. Hereditary factors have a minor impact on individual susceptibility with immediate
relatives of people with RCC.
9. Race: Renal cell carcinoma is more common in Northern European ancestry and North
Americans than Asian or African descent.
1
, Pathophysiology
Due to any risk factors
Tumor growth begins in the renal cortex-
tubular epithelium, anywhere in kidney
with clearly defined margin and continue
for sometime
Clinically manifestation of flank pain,
hematuria and abdominal mass
Hormones producing
paraneoplastic syndrome Compressing adjacent renal parenchyma and
surrounds blood vessels and constrict them
Hypercalcemia, hypertension, Renal vein, Lungs, bones, Lymph nodes,
hyperglycemia liver, Brain
Clinical Manifestations Continue
1. In early stage, renal cancer is asymptomatic.
SpreadsClassical triad
to • Lungs, of renal
bones cancer
•Lymph in advance
nodes,
stage are hematuria, palpable flank mass and
liver flank pain.
2. Routine physical examination revealsBrain
a palpable abdominal mass.
3. Painless hematuria (gross and intermittent).
4. Flank pain: It is on the side of the body between the hip and ribs. May be dull pain in
Continue
the back from pressure produced by compression.
Spreads to • Lungs, bones •Lymph nodes,
5. Colicky pain: It occurs, if clot or mass of tumor cells passes down the ureter.
liver
6. Renal cell carcinomas secrete parathyroid
Brainand erythropoietin that leads to manifestation
of hypocalcemia and erythrocytosis.
7. Anemia
8. Hypertension resulting from secretion of renin by the tumor.
Diagnostic Evaluation
1. Urine analysis: Urinalysis can test for sugar, protein and bacteria which can also serve
as indicators for cancer.
• A complete blood cell count can also provide additional information regarding the
severity and spreading of the cancer.
2. Intravenous pyelography or ultrasound: They are used to determine size of tumor.
UltrasOtund differentiates renal cyst from solid lesions.
3. Ultrasound, CT scan and MRI: It is used to delineate tumors. MRI is used to identifty
thrombus that may have formed in renal vein.
4. Blood test: It is done to check complete blood count with SMA-12 and liver function
test.
2
