Renal Cell Carcinoma (RCC)
Several types of cancer can develop in the kidneys. Renal cell
carcinoma (RCC), the most common form, accounts for
approximately 85% of all cases. In RCC, cancerous (malignant)
cells develop in the lining of the kidney's tubules and grow
into a mass called a tumor. In most cases, a single tumor
develops, although more than one tumor can develop within one
or both kidneys.
Early diagnosis of kidney cancer is important. As with most
types of cancer, the earlier the tumor is discovered, the
better a patient's chances for survival. Tumors discovered at
an early stage often respond well to treatment. Survival rates
in such cases are high. Tumors that have grown large or spread
(metastasized) through the bloodstream or lymphatic system to
other parts of the body are more difficult to treat and
present an increased risk for mortality.
Incidence and Prevalence
According to the National Cancer Institute, the highest
incidence of kidney cancer occurs in the United States,
Canada, Northern Europe, Australia, and New Zealand. The
lowest incidence is found in Thailand, China, and the
Philippines.
In the United States, kidney cancer accounts for approximately
3% of all adult cancers. According to the American Cancer
Society, about 32,000 new cases are diagnosed and about 12,000
people die from the disease annually. Kidney cancer occurs
most often in people between the ages of 50 and 70, and
affects men almost twice as often as women.
Smokers develop renal cell carcinoma about twice as often as
nonsmokers and develop cancer of the renal pelvis about 4
times as often. Not smoking is the most effective way to
prevent kidney cancer and it is estimated that the elimination
of smoking would reduce the rate of renal pelvis cancer by
one-half and the rate of renal cell carcinoma by one-third.
Wilms’ tumor accounts for about 6% of childhood cancers and is
the most common type of kidney cancer in children. Incidence
of Wilms’ tumor is higher in girls younger than the age of 5
and in African Americans.
The Kidneys
The kidneys are an essential part of the body's urinary
system. Each kidney is composed of about one million
microscopic "filtering packets" called glomeruli. The
glomeruli remove uremic waste products from the blood. Each
glomerulus connects to a long tube, called the tubule. Urine
made by the glomerulus moves down the tubule. Together, the
glomerulus and the tubule form a unit called a nephron. Each
nephron connects to progressively larger tubular branches,
until it reaches a large collection area called the calyx. The
calices form the funnel-shaped portion of the upper ureter
(renal pelvis). Urine moves from the renal pelvis to the
ureters, the large tubes that connect the kidney to the
bladder.
The kidneys produce three important hormones: erythropoietin (EPO),
which triggers the production of red blood cells in bones;
renin, which regulates blood pressure; and vitamin D, which
helps regulate the body's metabolism of calcium necessary for
healthy bones.
Risk Factors
There are several risk factors associated with the renal cell
carcinoma.
Smoking
There is strong evidence that cigarette, pipe, and cigar
smoking doubles a person's risk for developing RCC.
Researchers estimate that 25% to 30% of all renal cell cancers
are directly attributable to smoking.
Overuse of Painkillers
Medications containing phenacetin, which were once commonly
used over-the-counter painkillers, have been linked to RCC,
typically in patients who used them to excess. While these
drugs were removed from U.S. markets more than 20 years ago,
older Americans who used them may be at risk for RCC.
Chemical Exposure
Studies have shown that exposure to certain substances
increases the risk of RCC. Asbestos, once commonly used as an
insulating material, and cadmium, formerly an ingredient in
certain colored inks and paints, have been linked to kidney
cancer. People who may have come into contact with these
substances, such as construction and shipyard workers,
painters and printers, may have an increased risk for RCC.
Genetics
People with a family history of kidney cancer are at increased
risk for RCC. It is suspected that inherited genetic mutations
may be the cause, perhaps triggered by damage to the DNA that
forms genes; cigarette smoke, for example, is known to contain
chemicals that can damage the genes of kidney cells.
Other genetic mutations may cause two rare forms of kidney
cancer. Von Hippel-Lindau syndrome is a disease that causes
multiple tumors of the brain, spine, eyes, adrenal glands,
pancreas, inner ear, testicles, and kidneys. Tuberous
sclerosis is a disease characterized by lesions on the skin
and in the central nervous system, tumor growth, and seizures.
Other Risk Factors
Age — RCC
occurs most frequently in adults 50 - 70 years old.
Diet and
weight — High-fat diet and obesity may increase the risk
for RCC.
Extended
dialysis — Patients treated with long-term dialysis may
develop cysts in their kidneys, a risk factor for RCC.
Estrogen —
Test animals have developed RCC when given estrogens.
Gender — Men
are twice as likely as women to develop RCC.
Signs and Symptoms
The primary symptoms of RCC include the following:
Abdominal
mass or lump
Blood in the
urine (hematuria)
Fever
High blood
pressure (hypertension)
Pain in the
side (flank) or lower back not associated with injury
Persistent
fatigue
Rapid,
unexplained weight loss
Swelling
(edema) in the legs and ankles
Diagnosis
If the physician suspects RCC, a series of examinations,
procedures, and laboratory tests are performed to confirm the
diagnosis. A thorough physical examination is performed to
assess the patient's health and obtain information about
symptoms and a medical history is taken to determine if there
are risk factors for RCC.
Imaging Tests
One or more imaging tests are performed to obtain pictures of
the kidney(s) and locate abnormalities. Some imaging tests
require the injection of a special "tracer" material (dye or
low-level radioactive isotope) into the patient's bloodstream.
Computed tomography (CT scan)
CT scan is a type of x-ray that produces a series of
cross-sectional, three-dimensional images of internal organs
and glands. It can detect tumors and, in some cases, lymph
nodes enlarged by cancer.
Magnetic resonance imaging (MRI scan)
An MRI scan uses large magnets to project magnetic waves
through the body and create computer-generated,
cross-sectional images of internal organs.
Ultrasound
Ultrasound uses sound waves projected into the body to produce
an image of internal organs, structures, and tumors. In this
procedure, a gel is applied to the patient's pelvic and kidney
areas, and a small device that emits ultrasonic pulses is
slowly passed over the area. The sonic image produced is
viewed on a monitor.
Intravenous pyelogram (IVP)
An intravenous pyelogram (IVP) involves injecting a dye
containing iodine through a vein in the arm into the
bloodstream. The dye eventually collects in the urinary
system, where it improves the contrast for x-rays and produces
a well-defined image of the kidneys, ureters, and bladder. By
showing up as white on the dark x-ray film, the IVP can detect
tumors or damage caused by a tumor in the kidney.
In some cases, the physician may request an arteriogram or
venacavagram (IVP of the blood vessels that supply the
kidneys) to look for tumors in the connecting arteries and
veins.
Chest x-ray
A standard chest x-ray may be used to detect RCC that has has
spread (metastasized) to the lungs or bones in the chest.
Bone scan
This nuclear imaging procedure is used to detect the spread
(metastasis) of cancer to bones, when aggressive tumors and
metastasis are suspected. In a bone scan, a small amount of
low-level radioactive material is injected into a vein in the
arm. This material discloses metastatic cancer, as well as
some noncancerous diseases, in bones.
Laboratory tests
One or more laboratory tests are performed to confirm the
presence of RCC.
Urinalysis
More than half of all patients with RCC have blood in the
urine (hematuria). Often this blood is present in small
amounts or diffused in the urine so that it cannot be seen
with the naked eye (called microscopic hematuria). To detect
hematuria, a chemical test of the urine is performed. On
occasion, cells found in the urine are examined under a
microscope for abnormalities. This procedure is called urine
cytology.
Blood tests
Another laboratory procedure typically used in the diagnosis
of RCC involves microscopic examination and/or chemical
analysis of the patient's blood. These tests screen for the
following conditions which may indicate the presence of
cancer:
Anemia (too
few red blood cells; caused by internal bleeding, a common
cancer symptom)
Polycythemia
(too many red blood cells; sometimes caused by cancerous
tumors in the kidney that trigger the release of
erythropoitin [EPO], a hormone that increases red blood
cell production in bone marrow)
Hypercalcemia
(high blood calcium levels) and elevated liver enzymes
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Cystoscopy
Blood in the urine can result from other health problems,
such as kidney stones or traumatic kidney injury, so the
doctor may order a cystoscopy to determine precisely where
the internal bleeding is occurring. In cystoscopy, a long,
thin, rigid or flexible optical scope is inserted through
the urethra and into the bladder. The practitioner then
makes a visual examination of the urethra, bladder, and
kidneys to locate the site of bleeding.
Fine needle
aspiration
RCC tumors are made up of cancerous (malignant) cells that
grow into a mass. If a tumor is found through imaging or
other procedures, a cell sample may be taken for
microscopic examination.
Physicians usually avoid performing needle
biopsies of suspected kidney tumors because of the risk for
bleeding or other complications. Some tumors contain a
fluid-filled cyst. A small amount of this fluid can be drawn
out of the cyst for examination by a pathologist, who will
look for and identify the cancer cells. This can help the
physician determine an appropriate treatment plan. While no
longer common, a similar technique can be used to collect a
sample of solid tissue from a noncystic tumor.
Pathology
Cells that make up RCC tumors fall into four categories based
on their appearance under microscopic examination:
Clear cell
Granular cell
Mixed clear
and granular
Sarcomatoid
or spindle type
Most studies suggest that the type of cancer
cell indicates the relative aggressiveness of the disease.
Under a microscope, clear cell cancers are
the least abnormal. They are round or polygon-shaped and
contain an abundance of fat and sugar. The tumors they produce
are yellow to orange in color. Clear cell cancers are thought
to be the least likely to spread (aggressive) and usually
respond more favorably to treatment.
Few tumors contain only clear cells, however. Darker granular
cells usually are present to some degree. These have a larger,
darker nucleus and are full of tiny pink granules called
mitochondria. The tumors they produce tend to be gray to white
in color. Mitochondria are small, oval bodies that provide
energy for cell growth. Their presence indicates a more
aggressive form of cancer.
Tumors that contain both clear and granular cells are
considered mixed. This is the most common form of RCC and
indicates the most aggressive form of kidney cancer.
Mixed tumors that contain spindle shaped, sarcomatoid cells
have the least favorable prognosis. Although tumors composed
exclusively of spindle cells are uncommon, the presence of
sarcomatoid cells indicates a form of cancer that grows and
spreads quickly.
The grade of a cancer cell is an assessment of its appearance
compared to that of a normal, healthy cell. Grading is done on
a scale of 1 to 4: Grade 1 RCC cells differ little from normal
kidney cells, typically spread slowly, and have a good
prognosis for treatment. Grade 4 RCC cells look extremely
different and indicate an aggressive cancer with poor
prognosis.
Staging
Although grading and the identification of cancer cell types
help determine a patient's prognosis, most doctors believe
that the cancer's stage is a better indicator of a patient's
survivability.
Staging allows a physician to gauge the size and
location of tumors by using information gathered from imaging
studies such as CT scans and MRIs, and from pathology tests
and physical examinations.
Staging
factors that influence a patient's prognosis are:
Spread to
tissues surrounding the kidney
Spread to
contiguous organs
Spread to
nearby lymph nodes (the small, bean-shaped structures
found throughout the body that produce and store
infection-fighting cells)
Distant
metastasis
There are two staging systems for RCC,
Robson and TNM.
The Robson system classifies tumors as stages.
Stage I
The tumor is confined to the kidney and does not involve
the capsule of tissue that surrounds the kidney
Stage II
The tumor extends through the capsule of the kidney
Stage III
The tumor involves lymph node(s) or extends into the
renal vein (the main blood vessel that carries blood from
the kidney) or inferior vena cava (the large vein that
drains blood back to the heart)
Stage IV
The tumor has invaded organs adjacent to the kidney (e.g.,
pancreas or bowel) or shows evidence of distant spread to
organs such as the lungs
The TNM (tumor-node-metastasis) system uses
stages generally similar to those of the Robson system. This
staging system is becoming more widely accepted because it
provides a more detailed description of the tumor(s).
The TNM system stages RCC tumors at four intervals:
Stage I
Small tumors (less than 1 inch) without evidence of local
invasion; no lymph node involvement and absence of distant
disease
Stage II
Tumors larger than 1 inch without evidence of local
invasion; no lymph node involvement and absence of distant
disease
Stage III
Tumors of any size that involve one lymph node (less
than 1 inch); tumors that invade the adrenal gland or
surrounding renal tissues; tumors that invade the renal
vein or the inferior vena cava
Stage IV
A mixed group including tumors that invade adjacent
structures; any tumor that has evidence of distant spread;
any tumor in which more than one lymph node is involved
The TNM system also uses alphanumeric
subcategories to define areas and degrees of invasion. These
are as follows:
Primary tumor (T); all sizes measured in greatest dimension:
TX Primary
tumor cannot be assessed.
T0 No
evidence of primary tumor.
T1 Tumor 7
centimeters (cm) or less, limited to the kidney.
T2 Tumor more
than 7 cm, limited to the kidney.
T3 Tumor
extends into major veins or invades the adrenal gland or
surrounding tissue, but not beyond the Gerota's fascia
(the fibrous tissue surrounding the kidney that separates
it from adjacent musculature).
T3a - Tumor
invades the adrenal gland or surrounding tissue, but not
beyond the Gerota's fascia.
T3b - Tumor
grossly extends into the renal vein or veins (the main
blood vessels that carry blood from the kidney) or the
vena cava (the large vein that drains blood back to the
heart).
T4 Tumor
invades beyond the Gerota's fascia.
Regional lymph nodes (N):
NX Regional
lymph nodes cannot be assessed.
N0 No
regional node metastasis.
N1 -
Metastasis in a single regional lymph node.
N2 Metastasis
in more than one regional lymph node.
Treatment
Once a diagnosis of renal cell cancer has been confirmed and
the disease's stage determined, physician and patient decide
on a treatment plan. Factors that are considered include the
patient's age and overall health and the extent to which the
cancer has spread. For example, a patient with one healthy,
functioning kidney and one afflicted with an aggressive Stage
2 RCC is a more likely candidate for radical surgery than a
patient with only one kidney and a less aggressive Stage 1
cancer.
It is important that the patient and physician make an
informed decision together after considering all possible
options, side effects, and outcomes. A confident, positive
outlook can help the patient cope with the physical demands of
surgery and/or therapy and can improve the chances for
recovery.
A second opinion can provide additional information in the
decision-making process and help the patient feel that he or
she has made the right choice. Some insurance companies
require a second opinion before they approve payment for
treatment.
Treatment options include the following:
Surgery (to
remove cancerous tissue)
Chemotherapy
(using drugs to destroy cancer cells)
Radiation
therapy (using high-energy radiation to destroy cancer
cells and shrink tumors)
Hormone
therapy (using hormones to prevent cancer cell growth)
Biological or
Immunotherapy (using compounds produced by the body's
immune system, or laboratory-produced copies of them, to
destroy cancer cells)
Two or more
forms of treatment may be used in combination, such as
surgery to remove a primary tumor followed by radiation
treatment or chemotherapy to kill cancer cells that may
remain in the body.
Another form
of treatment, called gene therapy, is being explored by
researchers who think inherited genetic mutations may
cause many cases of RCC.
Eventually, a
process that uses normal genes to overcome or reverse the
cancer-causing process may be developed.
Surgery
Surgery usually is required to treat RCC. Without it, most
patients' chances for survival are poor. Several surgical
options are available to the patient and physician; which is
most appropriate depends on the patient's condition and the
cancer's stage.
Radical Nephrectomy
The most common form of surgery for RCC, radical nephrectomy
involves removal of the entire kidney, often along with the
attached adrenal gland, surrounding fatty tissues and nearby
lymph nodes (regional lymphadenectomy), depending upon how far
the cancer has spread.
Partial Nephrectomy
It may be possible to remove only the cancerous tissue and
part of the kidney if the tumor is small and confined to the
very top or bottom of the kidney. A partial nephrectomy may be
the procedure of choice for patients with RCC in both kidneys
and for those who have only one functioning kidney.
Arterial Embolization
This procedure usually is reserved for patients whose health
does not permit surgery, such as those with heart or lung
disease. In arterial embolization, a very small tube
(catheter) is inserted through a blood vessel in the groin and
passed up to the kidney. A small piece of gelatin sponge is
then injected into the artery that supplies blood to the
cancerous kidney. This cuts off the flow of blood to the
kidney and the cancerous tumor, and both die. The kidney
usually is surgically removed at a later date, if and when the
patient's health permits.
Surgical Risks
Any form of invasive surgery carries certain risks. Patients
contemplating kidney surgery should be advised of the
possibility of experiencing complications, such as the
following:
Damage to
blood vessels (aorta or vena cava)
Damage to
organs (spleen, pancreas, large or small bowel)
Failure of
the remaining kidney
Hemorrhage
(bleeding) during surgery (intraoperative) or after
surgery (postoperative)
Incisional
hernia (bulging of the internal organs beneath the
surgical incision, caused by imperfect healing or damage
to the overlying muscles)
Infection
Pneumothorax
(unwanted air in the chest cavity)
Postoperative Prognosis
Renal cell cancer is unpredictable. It is the second most
common tumor to undergo spontaneous regression following
removal of the primary lesion; this occurs about 0.5% of the
time. Another unusual characteristic of RCC is the variability
in the growth of the primary tumor.
Once metastasis occurs, prognosis depends on the extent of the
spread and the interval between appearance of metastases and
the removal of the kidney.
Overall, the 5-year survival rate for RCC -- all stages
combined -- is about 40-45%.
Follow-up Care and Recurrent Kidney
Cancer
Some patients who undergo surgery to remove a cancerous kidney
or kidney tumors experience a recurrence of the disease. For
this reason, patients usually undergo a regimen of follow-up
examinations after surgery, typically at 3-month intervals for
the first year. These examinations include a complete physical
examination, chest x-ray, complete blood tests, and
assessments of liver and kidney function.
If the disease recurs but remains confined to a few small
areas, additional surgery may be recommended. Radiation,
biological, or chemotherapy also may be used in addition to
surgery (adjuvant treatment) or to relieve symptoms
(palliative treatment).
Nonsurgical Treatments Chemotherapy
Chemotherapy uses chemical agents to destroy cancer cells
throughout the body. Unfortunately, RCC has proven to be
particularly resistant to chemotherapy. Research to develop
more effective chemotherapy drugs to treat RCC is ongoing,
however, and a number of them are currently being tested.
Radiation Therapy
Radiation therapy involves using high-energy x-rays to shrink
tumors and destroy cancer cells. This treatment may be
delivered as a focused beam that is projected into the body
(called external therapy) or in the form of radioactive
materials placed at the site of the cancer through thin
plastic tubes (called brachytherapy).
Radiation therapy is used often as follow-up (adjuvant)
treatment to destroy cancer cells that remain in the body
after a radical or partial nephrectomy.
It also may be used as palliative therapy to lessen pain or
bleeding in patients with inoperable or widespread metastatic
RCC. In such cases, there is no expectation of cure; the
object is simply to ease the dying patient's discomfort.
Radiation therapy alone has a relatively low success rate in
treating RCC, and often produces unpleasant side effects:
Diarrhea
Fatigue
Headaches and
cognitive problems (if treating metastatic cancer of the
brain)
Lung and
respiratory problems (if treating cancer that has spread
to the lungs or bones in the chest)
Nausea
Skin
irritations
Hormone Therapy
Agents such as estrogen, progesterone, and tamoxifen have been
used with varying degrees of success to stop some types of
cancer from growing. There is little evidence, however, that
hormone therapy, either primary or adjuvant, is effective when
used to treat RCC. Some recent studies show success rates of
5% to 10%. At best, it remains a subject for future research.
Biological Therapy
Over the last 10 years, there has been much interest in the
use of biological agents, primarily interleukin and
interferon, to boost, restore, or direct the patient's immune
system to fight RCC in the same way it would fight an
infection. There are data to suggest that these agents
effectively treat this disease and can at times produce
complete remissions. Both interleukin and interferon are
approved by the FDA for treating metastatic RCC.
Chemobiological Therapy
Some recent studies suggest that combining biological therapy
with chemotherapy (chemobiological) therapy produces
significantly higher response rates than biological therapy
alone, although the data need to be confirmed in a larger
study.
The side effects of chemobiological therapy include, but are
not limited to the follwing:
Depression
Fatigue
Fever
Fluid
retention and associated weight gain
Loss of
appetite
Nausea
Renal and
liver failure
Risk of
infection and bleeding
Skin rash
Other Types of
Kidney Cancer Transitional Cell Carcinoma
About 6% to 7% of kidney cancers begin not in the kidney
itself, but in the renal pelvis, the point where the kidney
joins the tube that carries urine form the kidney to the
bladder (ureter). These tumors are called transitional cell
carcinomas and are made up of cancer cells different from
those that characterize RCC. Research indicates these tumors
are caused by cigarette smoking.
The symptoms of transitional cell carcinoma are quite similar
to those of RCC, and include hematuria and back or flank pain.
If found early, these cancers have a 90% cure rate. Treatment
usually involves surgical removal of the kidney, ureter, and
portion of the bladder connecting to the ureter. Depending on
the stage of the cancer, chemotherapy and radiation may be
used as adjuvant treatments.
The prognosis for cure declines sharply when the cancer
invades the ureter wall or penetrates the kidney. Regular
follow-up examinations after surgery are important, as
transitional cell carcinoma is prone to recurrence.
Wilms' Tumor
A relatively rare form of kidney cancer, Wilms' tumor (also
known as nephroblastoma) accounts for about 5% to 8% of kidney
tumors in children. It occurs in about 7 out of every 1
million children around the world per year, regardless of
race, and is thought to be caused by genetic mutation that
causes abnormal growth within the tubules of the kidney
nephrons. The disease occurs equally in boys and girls. It
typically first appears in children between 2 and 5 years of
age but has been known to occur rarely in adolescents as old
as 15.
Wilms' tumor can arise anywhere within the kidney's tissues.
Untreated, it can spread to the veins, lymph nodes, adrenal
glands, large or small bowel, and liver. Fortunately, advances
in radiation and chemotherapy over the past few decades,
pediatric anesthesia, and surgery have made Wilms' tumor one
of the most curable of all childhood cancers. Today the 5-year
survival rate approaches 90%.
Renal Sarcoma
Renal sarcoma is a rare disease of the kidney's connective
tissues that accounts for less than 1% of all kidney tumors.
Its symptoms are similar to those of RCC: hematuria, pain in
the back or flank, or a lump and mass in the abdomen. In most
cases, it is impossible to differentiate renal sarcoma from
RCC externally, so the diagnosis usually is made after
examination of a CT scan or MRI procedure.
Such tumors will grow and spread to adjacent organs, bones,
and lymph nodes if left untreated. The only potentially
curative form of treatment is surgery, usually radical or
partial nephrectomy, sometimes with radiation or chemotherapy.
Benign Kidney Tumors
Benign tumors are noncancerous. Most are asymptomatic, are
discovered incidentally, and are not immediately life
threatening.
Renal Adenoma
Renal adenomas are the most common form of benign, solid
kidney tumor, and are typically small, low-grade growths.
Their cause is unknown. Because they usually are asymptomatic,
their incidence is unknown, although one study found them
present in 7% to 22% of autopsy cadavers. In rare cases, when
they have grown large enough to affect kidney function or
adjacent vessels, symptoms similar to those of RCC may occur.
Adenoma cells look much like low-grade RCC cells under a
microscope. In fact, while they are considered benign, there
is presently no known cellular classification to differentiate
them from RCCs. Many researchers and physicians regard them as
early stage precancers, to be treated accordingly.
Renal Oncocytoma
Oncocytoma is a benign, usually asymptomatic tumor that can
grow quite large. They can develop throughout the body and are
not unique to the kidneys. Their cause is unknown, and they
appear with greater frequency in men than in women. Typically,
they are discovered incidentally by ultrasound, IVP, CT, or
MRI scan for an unrelated health problem.
Under a microscope, many oncocytomas resemble early-stage RCCs.
Many physicians regard them as precancerous growths to be
surgically removed unless the patient's age or overall health
condition dictates otherwise.
Angiomyolipoma
Also known as renal hamartoma, angiomyolipomas are rare benign
tumors usually caused by an inherited genetic mutation. They
can occur on an isolated, individual basis, but most often are
associated with a rare genetic disease called tuberous
sclerosis, which can cause tumors in the skin, kidneys, brain,
and other organ systems. About 80% of persons diagnosed with
tuberous sclerosis also have angiomyolipoma.
In patients without tuberous sclerosis, these tumors most
often occur in middle-aged women. Most cases are discovered
when the patient undergoes a CT scan for an unrelated
abdominal problem, suffers gastrointestinal discomfort, or
suffers a sudden hemorrhage caused by the rupture of a large
tumor.
Management of the condition depends on the size of the tumors
and the severity of the symptoms they produce. Asymptomatic
patients and those with small tumors usually are not treated;
instead, they are observed periodically with an eye toward
surgery if the tumors grow or produce symptoms. Because of the
potential for spontaneous rupture and life-threatening
hemorrhage, patients with large tumors usually are considered
candidates for some form of surgical treatment, ranging from
partial nephrectomy to arterial embolization.
Fibroma
Fibromas are tumors of the fibrous tissue on, in, or
surrounding the kidney. They are rare and are more common in
women. Their cause is unknown and most do not cause symptoms.
Usually they grow on the periphery of the kidney and can
become large before becoming clinically obvious. While
generally benign, these tumors have no special characteristics
to differentiate them from malignant tumors of the kidney.
Because of this uncertainty of diagnosis, partial or radical
nephrectomy is the standard treatment.
Lipoma
Lipomas are rare renal tumors that originate in the fat cells
within the renal capsule or surrounding tissue. They typically
occur in middle-aged women, can grow very large, and produce
pain and hematuria. Like many benign tumors, they may become
cancerous and usually are treated with total nephrectomy.
For more information about The Austin Diagnostic Clinic's
urology department or this topic,
please call 512/901-4021.
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