RENAL CELL CARCI...

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Definition

Renal cell carcinoma is a type of kidney cancer in which the cancerous cells are found in the lining of very small tubes (tubules) in the kidney.

Alternative Names

Renal cancer; Kidney cancer; Hypernephroma; Adenocarcinoma of renal cells; Cancer - kidney

Causes, incidence, and risk factors

Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in men ages 50-70.

The exact cause is unknown.

Risk factors include:

• Dialysis treatment
• Family history of the disease
• Genetics
• Smoking
• Von Hippel-Lindau disease (a hereditary disease that affects the capillaries of the brain, eyes, and other body parts)

Symptoms

• Abdominal pain
• Abnormal urine color (dark, rusty, or brown)
• Back pain
• Blood in the urine
• Emaciated, thin, malnourished appearance
• Enlargement of the veins around a testicle (varicocele)
• Flank pain
• Swelling or enlargement of the abdomen
• Unintentional weight loss of more than 5% of body weight

Other symptoms that can occur with this disease:

• Constipation
• Cold intolerance
• Excessive hair growth in females
• Paleness
• Vision abnormalities

Sometimes both kidneys are involved. The cancer spreads easily, most often to the lungs and other organs. In about one-third of patients, the cancer has already spread (metastasized) at the time of diagnosis.

Signs and tests

Pressing with the fingers (palpation) on the abdomen may show a mass or organ enlargement, particularly of the kidney or liver. Men may have a varicocele in the scrotum (a varicocele that is only on the right side is especially suspicious.)

Tests include:

• Abdominal CT scan
• Complete blood count (CBC)
• Intravenous pyelogram (IVP)
• Liver function tests
• Renal arteriography
• Serum calcium
• Ultrasound of the abdomen and kidney
• Urine cytology
• Urine test (urinalysis)

The following tests may be performed to see if the cancer has spread:

• Abdominal CT scan
• Abdominal MRI
• Bone scan
• Chest x-ray
• PET scan

Reviewer Info: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., 02/12/2009