Introduction
Renal tumors are neoplasms arising from the kidney parenchyma, renal pelvis or the tissues that surround them. For the exam you need to know the main histological types, above all renal cell carcinoma, its risk factors and clinical presentation, how it is diagnosed and staged and told apart from benign masses and other flank masses, and the principles of surgical and systemic treatment and prognosis.
Classification and epidemiology
Renal cell carcinoma (RCC) accounts for about 85 percent of primary malignant kidney tumors in adults. It is more common in men and usually presents between the ages of 50 and 70. Other types are less frequent and have different behaviour and treatment.
Benign tumors include angiomyolipoma, which contains fat and is often diagnosed by its fat content on imaging, and oncocytoma, which is hard to tell from RCC before surgery.
Causes and risk factors
- Smoking, which is the most important modifiable risk factor
- Obesity and arterial hypertension
- Long-term dialysis, which causes acquired cystic kidney disease with increased risk of tumor
- Hereditary syndromes: von Hippel-Lindau disease, hereditary papillary RCC (MET mutation), tuberous sclerosis and hereditary leiomyomatosis with RCC
- Occupational exposure to some chemicals and long-term analgesic abuse (less certain)