Skip to main content
SpringerLink
Log in

Renal Cell Carcinoma: Clinical Presentation and Diagnosis

  • Chapter
Clinical Management of Renal Tumors

  • 797 Accesses

Abstract

Renal cell carcinoma remains the most common malignant kidney tumor. The yearly incidence of renal cancer is rising, which may be related to a number of environmental factors. Due to advances in radiographic imaging modalities and surgical techniques, cure rates for low-stage renal cancer have dramatically improved. Unfortunately, the same cannot be said for advanced kidney cancer, which remains incurable despite medical progress. This chapter reviews the signs, symptoms, common clinical presentations of patients with renal cancer, and discusses the current approaches to establishing a diagnosis of renal cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Cancer Facts and Figures 2004. American Cancer Society, Atlanta, GA, 2005.

    Google Scholar 

  2. Linehan WM, Walther MM, Zbar B. The genetic basis of cancer of the kidney. J Urol 2003;170(6 pt 1):2163–2172.

    Article  PubMed  CAS  Google Scholar 

  3. Chow WH, Devesa SS, Warren JL, Fraumeni JF Jr. Rising incidence of renal cell cancer in the United States. JAMA 1999;281(17):1628–1631.

    Article  PubMed  CAS  Google Scholar 

  4. Chow WH, Gridley G, Fraumeni JF Jr, Jarvholm B. Obesity, hypertension, and the risk of kidney cancer in men. N Engl J Med 2000;343(18):1305–1311.

    Article  PubMed  CAS  Google Scholar 

  5. Hafez KS, Novick AC, Butler BP. Management of small solitary unilateral renal cell carcinomas: impact of central versus peripheral tumor location. J Urol 1998;159(4):1156–1160.

    Article  PubMed  CAS  Google Scholar 

  6. Skinner DG, Colvin RB, Vermillion CD, Pfister RC, Leadbetter WF. Diagnosis and management of renal cell carcinoma. A clinical and pathologic study of 309 cases. Cancer 1971;28(5):1165–1177.

    Article  PubMed  CAS  Google Scholar 

  7. Sweeney JP, Thornhill JA, Graiger R, McDermott TE, Butler MR. Incidentally detected renal cell carcinoma: pathological features, survival trends and implications for treatment. Br J Urol 1996; 78(3):351–353.

    PubMed  CAS  Google Scholar 

  8. Bretheau D, Koutani A, Lechevallier E, Coulange C. A French national epidemiologic survey on renal cell carcinoma. Oncology Committee of the Association Francaise d’Urologie. Cancer 1998;82(3):538–544.

    Article  PubMed  CAS  Google Scholar 

  9. Jayson M, Sanders H. Increased incidence of serendipitously discovered renal cell carcinoma. Urology 1998;51(2):203–205.

    Article  PubMed  CAS  Google Scholar 

  10. Tsui KH, Shvarts O, Smith RB, Figlin R, de Kernion JB, Belldegrun A. Renal cell carcinoma: prognostic significance of incidentally detected tumors. [see comment]. J Urol 2000;163(2):426–430.

    Article  PubMed  CAS  Google Scholar 

  11. Zisman A, Pantuck AJ, Chao DH, et al. Renal cell carcinoma with tumor thrombus: is cytoreductive nephrectomy for advanced disease associated with an increased complication rate? J Urol 2002;168(3):962–967.

    Article  PubMed  Google Scholar 

  12. Eggener SE, Rubenstein JR, Smith ND, Nadler RL, Kontak J. Renal tumors in young adults. J Urol 2004;171(1):106–110.

    Article  PubMed  CAS  Google Scholar 

  13. Thompson IM, Peek M. Improvement in survival of patients with renal cell carcinoma—the role of the serendipitously detected tumor. J Urol 1988;140(3):487–490.

    PubMed  CAS  Google Scholar 

  14. Leslie JA, Prihoda T, Thompson IM. Serendipitous renal cell carcinoma in the post-CT era: continued evidence in improved outcomes. Urol Oncol 2003;21(1):39–44.

    PubMed  Google Scholar 

  15. Bosniak MA, Birnbaum BA, Krinsky GA, Waisman J. Small renal parenchymal neoplasms: further observations on growth. [see comment]. Radiology 1995;197(3):589–597.

    PubMed  CAS  Google Scholar 

  16. Rendon RA, Stanietzky N, Panzarella T, et al. The natural history of small renal masses. J Urol 2000;164(4):1143–1147.

    Article  PubMed  CAS  Google Scholar 

  17. Oda T, Miyao N, Takahashi A, et al. Growth rates of primary and metastatic lesions of renal cell carcinoma. Int J Urol 2001;8(9):473–477.

    Article  PubMed  CAS  Google Scholar 

  18. Kassouf WAA. Natural history of renal masses followed expectantly. J Urol 2004;171(1):111–113.

    Article  PubMed  CAS  Google Scholar 

  19. Tosaka A, Ohya K, Yamada K, et al. Incidence and properties of renal masses and asymptomatic renal cell carcinoma detected by abdominal ultrasonography. J Urol 1990;144(5):1097–1099.

    PubMed  CAS  Google Scholar 

  20. Luciani LG, Cestari R, Tallarigo C. Incidental renal cell carcinoma-age and stage characterization and clinical implications: study of 1092 patients (1982–1997). Urology 2000;56(1):58–62.

    Article  PubMed  CAS  Google Scholar 

  21. Licht MR, Novick AC, Goormastic M. Nephron sparing surgery in incidental versus suspected renal cell carcinoma. J Urol 1994;152(1):39–42.

    PubMed  CAS  Google Scholar 

  22. Holt BA, Holmes SA, Kirby RS. Renal cell carcinoma presenting with orbital metastases. Br J Urol 1995;75(2):246–247.

    Article  PubMed  CAS  Google Scholar 

  23. Sesenna E, Tullio A, Piazza P. Treatment of craniofacial metastasis of a renal adenocarcinoma: report of case and review of literature. J Oral Maxillofac Surg 1995;53(2):187–193.

    Article  PubMed  CAS  Google Scholar 

  24. Green LK, Ro JY, Mackay B, Ayala AG, Luna MA. Renal cell carcinoma metastatic to the thyroid. Cancer 1989;63(9):1810–1815.

    Article  PubMed  CAS  Google Scholar 

  25. Pagano S, Ruggeri P, Franzoso F, Brusamolino R. Unusual renal cell carcinoma metastasis to the gallbladder. Urology 1995;45(5):867–869.

    Article  PubMed  CAS  Google Scholar 

  26. Dousset B, Andant C, Guimbaud R, et al. Late pancreatic metastasis from renal cell carcinoma diagnosed by endoscopic ultrasonography. Surgery 1995;117(5):591–594.

    Article  PubMed  CAS  Google Scholar 

  27. Knight EL Jr, Kandzari SJ, Milam DF. Renal cell carcinoma presenting as vaginal bleeding. Urology 1977;10(3):249–250.

    Article  Google Scholar 

  28. Torne A, Pahisa J, Castelo-Branco C, Fabregues F, Mallofre C, Iglesias X. Solitary vaginal metastasis as a presenting form of unsuspected renal adenocarcinoma. Gynecol Oncol 1994;52(2):260–263.

    Article  PubMed  CAS  Google Scholar 

  29. Cherukuri SV, Johenning PW, Ram MD. Systemic effects of hypernephroma. Urology 1977; 10(2):93–97.

    Article  PubMed  CAS  Google Scholar 

  30. Gold PJ, Fefer A, Thompson JA. Paraneoplastic manifestations of renal cell carcinoma. Semin Urol Oncol 1996;14(4):216–222.

    PubMed  CAS  Google Scholar 

  31. Sufrin G, Mirand EA, Moore RH, Chu TM, Murphy GP. Hormones in renal cancer. J Urol 1977;117(4):433–438.

    PubMed  CAS  Google Scholar 

  32. Da Silva JL, Lacombe C, Bruneval P, et al. Tumor cells are the site of erythropoietin synthesis in human renal cancers associated with polycythemia. Blood 1990;75(3):577–582.

    PubMed  Google Scholar 

  33. Novick AC, Campbell SC. Renal tumors. In: Walsh PC, Retik AB, Vaughn ED, Wein AJ, eds. Camp-bell’s Urology. Philadelphia: Saunders, 2002:2672–2731.

    Google Scholar 

  34. Chuang YC, Lin AT, Chen KK, Chang YH, Chen MT, Chang LS. Paraneoplastic elevation of serum alkaline phosphatase in renal cell carcinoma: incidence and implication on prognosis. J Urol 1997;158(5):1684–1687.

    Article  PubMed  CAS  Google Scholar 

  35. Walther MM, Patel B, Choyke PL, et al. Hypercalcemia in patients with metastatic renal cell carcinoma: effect of nephrectomy and metabolic evaluation. J. Urol 1997;158(3 pt 1):733–739.

    PubMed  CAS  Google Scholar 

  36. Papac RJ, Poo-Hwu WJ. Renal cell carcinoma: a paradigm of lanthanic disease. Am J Clin Oncol 1999;22(3):223–231.

    Article  PubMed  CAS  Google Scholar 

  37. Cronin RE, Kaehny WD, Miller PD, et al. Renal cell carcinoma: unusual systemic manifestations. Medicine 1976;55(4):291–311.

    Article  PubMed  CAS  Google Scholar 

  38. Marinides GN, Hajdu I, Gans RO. A unique association of renal carcinoma with sarcoid reaction in the kidney. Nephron 1994;67(4):477–480.

    Article  PubMed  CAS  Google Scholar 

  39. Solon AA, Gilbert CS, Meyer C. Myopathy as a paraneoplastic manifestation of renal cell carcinoma. Am J Med 1994;97(5):491–492.

    Article  PubMed  CAS  Google Scholar 

  40. Forman D, Rae-Grant AD, Matchett SC, Cowen JS. A reversible cause of hypercapnic respiratory failure: lower motor neuronopathy associated with renal cell carcinoma. Chest 1999;115(3):899–901.

    Article  PubMed  CAS  Google Scholar 

  41. Warshauer DM, McCarthy SM, Street L, et al. Detection of renal masses: sensitivities and specificities, of excretory urography/linear tomography, US, and CT. Radiology 1988;169(2):363–365.

    PubMed  CAS  Google Scholar 

  42. Forman HP, Middleton WD, Melson GL, McClennan BL. Hyperechoic renal cell carcinomas: increase in detection at US. Radiology 1993;188(2):431–434.

    PubMed  CAS  Google Scholar 

  43. Mihara S, Kuroda K, Yoshioka R, Koyama W. Early detection of renall cell carcinoma by ultrasonographic screening—based on the results of 13 years screening in Japan. Ultrasound Med Biol 1999;25(7):1033–1039.

    Article  PubMed  CAS  Google Scholar 

  44. Sheth S, Scatarige JC, Horton KM, Corl FM, Fishman EK. Current concepts in the diagnosis and management of renal cell carcinoma: role of multidetector ct and three-dimensional CT. Radiographics 2001;21 (Spec. No.):S237–S254.

    PubMed  Google Scholar 

  45. Zagoria RJ. Imaging of small renal masses: a medical success story. AJR 2000;175(4):945–955.

    PubMed  CAS  Google Scholar 

  46. Bosniak MA, Rofsky NM. Problems in the detection and characterization of small renal masses. Radiology 1996;198(3):638–641.

    PubMed  CAS  Google Scholar 

  47. Siegel CL, McFarland EG, Brink JA, Fisher AJ, Humphrey P, Heiken JP. CT of cystic renal masses: analysis of diagnostic performance and interobserver variation. AJR 1997;169(3):813–818.

    PubMed  CAS  Google Scholar 

  48. Curry NS, Cochran ST, Bissada NK. Cystic renal masses: accurate Bosniak classification requires adequate renal CT. AJR 2000;175(2):339–342.

    PubMed  CAS  Google Scholar 

  49. Cohan RH, Sherman LS, Korobkin M, Bass JC, Francis IR. Renal Masses: Assessment of corticomedullary-phase and nephrographic-phase CT scans. Radiology 1995;196:445–451.

    PubMed  CAS  Google Scholar 

  50. Birnbaum BA, Jacobs JE, Ramchandani P. Multiphasic renal CT: comparison of renal mass enhancement during the corticomedullary and nephrographic phases. Radiology 1996;200(3):753–758.

    PubMed  CAS  Google Scholar 

  51. Bae KT, Heiken JP, Siegel CL, Bennett HF. Renal cysts: is attenuation artifactually increased on contrast-enhanced CT images? Radiology 2000;216(3):792–796.

    PubMed  CAS  Google Scholar 

  52. Maki DD, Birnbaum BA, Chakraborty DP, Jacobs JE, Carvalho BM, Herman GT. Renal cyst pseudoenhancement: beam-hardening effects on CT numbers. Radiology 1992;213(2):468–472.

    Google Scholar 

  53. Israel GM, Bosniak MA. Calcification in cystic renal masses: is it important in diagnosis? Radiology 2003;226(1):47–52.

    Article  PubMed  Google Scholar 

  54. Rofsky NM, Weinreb JC, Bosniak MA, Libes RB, Birnbaum BA. Renal lesion characterization with gadolinium-enhanced MR imaging: efficacy and safety in patients with renal insufficiency. Radiology 1991;180(1):85–89.

    PubMed  CAS  Google Scholar 

  55. Nelson KL, Gifford LM, Lauber-Huber C, Gross CA, Lasser TA. Clinical safety of gadopentetate dimeglumine. Radiology 1995;196(2):439–443.

    PubMed  CAS  Google Scholar 

  56. Balci NC, Semelka RC, Patt RH, et al. Complex renal cysts: findings on MR imaging. AJR 1999;172(6):1495–1500.

    PubMed  CAS  Google Scholar 

  57. Juul N, Torp-Pedersen S, Gronvall S, Holm HH, Koch F, Larsen S. Ultrasonically guided fine needle aspiration biopsy of renal masses. J Urol 1985;133(4):579–581.

    PubMed  CAS  Google Scholar 

  58. Campbell SC, Novick AC, Herts B, et al. Prospective evaluation of fine needle aspiration of small, solid renal masses: accuracy and morbidity. Urology 1997;50(1):25–29.

    Article  PubMed  CAS  Google Scholar 

  59. Niceforo J, Coughlin BF. Diagnosis of renal cell carcinoma: value of fine-needle aspiration cytology in patients with metastases or contraindications to nephrectomy. AJR 1993;161(6):1303–1305.

    PubMed  CAS  Google Scholar 

  60. Dechet CB, Sebo T, Farrow G, Blute ML, Engen DE, Zincke H. Prospective analysis of intraoperative frozen needle biopsy of solid renal masses in adults. J Urol 1999;162(4):1282–1284.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH

    Venkatesh Krishnamurthi MD

Authors
  1. Venkatesh Krishnamurthi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, OH

    Ronald M. Bukowski MD

  2. Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH

    Andrew C. Novick MD

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Krishnamurthi, V. (2008). Renal Cell Carcinoma: Clinical Presentation and Diagnosis . In: Bukowski, R.M., Novick, A.C. (eds) Clinical Management of Renal Tumors. Humana Press. https://doi.org/10.1007/978-1-60327-149-3_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-149-3_8

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-251-3

  • Online ISBN: 978-1-60327-149-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation