Renal Cell Carcinoma

Renal Cell Carcinoma - What is Renal Cell Carcinoma?

Renal cell carcinoma (RCC, also known as hypernephroma) is a kidney cancer that originates in the lining of the proximal convoluted tubule, the very small tubes in the kidney that filter the blood and remove waste products.

RCC is the most common type of kidney cancer in adults, responsible for approximately 80% of cases.

It is also known to be the most lethal of all the genitourinary tumors.

Initial treatment is most commonly a radical or partial nephrectomy and remains the mainstay of curative treatment.

Where the tumour is confined to the renal parenchyma, the 5-year survival rate is 60-70%, but this is lowered considerably where metastases have spread.

It is resistant to radiation therapy and chemotherapy, although some cases respond to immunotherapy.

Targeted cancer therapies such as sunitinib, temsirolimus, bevacizumab, interferon-alpha, and possibly sorafenib have improved the outlook for RCC (progression-free survival), although they have not yet demonstrated improved survival.

Recent genetic studies have altered the approaches used in classifying renal cell carcinoma. The following system can be used to classify these tumors:

  • Clear cell carcinoma (VHL and others on chromosome 3)
  • Papillary carcinoma (MET, PRCC)
  • Chromophobe renal carcinoma
  • Collecting duct carcinoma

Renal epithelial neoplasms have characteristic cytogenetic aberrations that can aid in classification. See also Atlas of Genetics and Cytogenetics in Oncology and Haematology.

  • Clear cell carcinoma: loss of 3p
  • Papillary carcinoma: trisomy 7, 16, 17
  • Chromophobe carcinoma: hypodiploid with loss of chromosomes 1, 2, 6, 10, 13, 17, 21

Array-based karyotyping can be used to identify characteristic chromosomal aberrations in renal tumors with challenging morphology. Array-based karyotyping performs well on paraffin embedded tumors and is amenable to routine clinical use. See also Virtual Karyotype for CLIA certified laboratories offering array-based karyotyping of solid tumors.

Other associated genes include TRC8, OGG1, HNF1A, HNF1B, TFE3, RCCP3, and RCC17.

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Renal Cell Carcinoma Epidemiology

The incidence of renal cell cancer has been rising steadily. Nearly 51190 new diagnoses and 12890 deaths reported in the United States in 2007.

It is more common in men than women: the male-to-female ratio is 1.6:1 and has been decreasing over the last decade. Blacks have a slightly higher rate of renal cell cancer than whites.

The reasons for this are not clear.

Note: in epidemiology, RCC is registered together with renal pelvis carcinoma, which is predominantly transitional cell type.

In Europe the incidence of RCC has doubled in the period from 1975 to 2005. RCC accounted for 3777 deaths in the UK in 2006; male 2372, female 1820.

This article is licensed under the Creative Commons Attribution-ShareAlike License. It uses material from the Wikipedia article on "Renal cell carcinoma" All material adapted used from Wikipedia is available under the terms of the Creative Commons Attribution-ShareAlike License. Wikipedia® itself is a registered trademark of the Wikimedia Foundation, Inc.

Renal Cell Carcinoma Symptoms

A wide range of symptoms can be present with renal carcinoma depending on which areas of the body have been affected.

The classic triad is hematuria (blood in the urine), flank pain and an abdominal mass. This triad only occurs in 10-15% of cases, and is generally indicative of more advanced disease.

Today, the majority of renal tumors are asymptomatic and are detected incidentally on imaging, usually for an unrelated cause.

Signs may include:

  • Abnormal urine color (dark, rusty, or brown) due to blood in the urine (found in 60% of cases)
  • Loin pain (found in 40% of cases)
  • Abdominal mass (25% of cases)
  • Malaise, weight loss or anorexia (30% of cases)
  • Polycythemia (5% of cases). This is due to blockage of the left testicular vein by tumor invasion of the left renal vein; this typically does not occur on the right as the right gonadal vein drains directly into the inferior vena cava.
  • Vision abnormalities
  • Pallor or plethora
  • Hirsutism - Excessive hair growth (females)
  • Constipation
  • Hypertension (high blood pressure) resulting from secretion of renin by the tumour (30% of cases) which occur in 9% of the patients
  • Cold intolerance
  • Back pain
  • Chronic fatigue
  • Leg and ankle swelling
  • Loss of appetite

This article is licensed under the Creative Commons Attribution-ShareAlike License. It uses material from the Wikipedia article on "Renal cell carcinoma" All material adapted used from Wikipedia is available under the terms of the Creative Commons Attribution-ShareAlike License. Wikipedia® itself is a registered trademark of the Wikimedia Foundation, Inc.