RENAL CELL CARCINOMA

Renal cell carcinoma or hypernephroma arises from the proximal tubular epithelium

The average presentation is 55 years.

The cause is unknown

Cigarette smoking is a significant risk factor.

Renal cell carcinoma may be single, multiple or occasionally bilateral.

Clinical features

• Painless Hematuria (in 60%) is the most common presentation. It may be gross or microscopic.

• Flank pain

. Abdominal mass

• Triad of flank pain, painless hematuria and mass are present in 10-15% cases.

• Symptoms of metastatic disease such as cough, bone pain occur in 20-30% of cases.

Metastasis

Regional lymph node

Bone

lungs

Liver

Investigations

• Ultrasound kidneys: show mass

• CT scan: required to assess the spread of tumour

• Chest x-ray: to assess the metastasis

• Bone scan: To assess the involvement of the bone.

Management

• Removal of the affected kidney, along with adrenal gland and regional lymph nodes for localized non-metastatic tumour.

• Radiotherapy relieves pain due to metastasis.

• Five-year survival for tumours confined to the renal capsule 90-100% while 0-15% when lymph nodes are involved.