Renal cell carcinoma

Renal cell carcinoma (RCC), also called renal adenocarcinoma, clear cell carcinoma or renal parenchymal carcinoma, is an adenocarcinoma from renal tubular epithelium; 85% are clear cell, with granular and mixed variants. Symptoms are variable and easily misdiagnosed. Hematuria is the most common sign but occurs only after tumor invades the renal pelvis (not early). The "triad" (hematuria, pain, mass) is present in only ~10%. Diagnosis requires lab/imaging/pathology. Treatment: surgery for localized disease; multidisciplinary integrated care for metastatic. Traditional Chinese medicine is used adjunctively to improve immunity and prevent recurrence.

Common Symptoms

Lower abdominal mass; weight loss; flank pain with renal tenderness; hemoptysis; fatigue; dull lower abdominal ache/fullness

Causes

Smoking (RR=2), high BMI, hypertension are independent risk factors. Metal workers, printers, coke workers, dry cleaners, petrochemical workers have higher risk. Familial RCC with chromosome 3 defects; VHP syndrome has 28-45% RCC risk. High dairy/animal protein/fat and low fruit/vegetable intake are risk factors. Analgesic abuse (phenacetin) raises renal pelvis cancer risk; diuretics may promote. Red vine grass is suspected. Usually unilateral single lesion (~2% bilateral/multifocal); no true capsule but pseudocapsule; yellow/brown cut with hemorrhage/necrosis/fibrosis/calcification; may invade renal vein/IVC/right atrium as tumor thrombus; ipsilateral adrenal involved ~10%; metastases to lung/bone/brain/liver/skin/thyroid. Histology: clear cells (10-40 µm, glycogen/lipid-rich, clear on HE), granular cells, spindle cells. Fuhrman grading based on nuclei. Robson/TNM staging.

Treatment

Drug therapy; supportive care

Prevention

Primary: quit smoking/alcohol, healthy lifestyle, exercise, protect against cadmium exposure, avoid phenacetin, treat renal cysts, eat anticancer foods. Secondary: screening ultrasound; investigate high ESR/hypercalcemia/anemia; watch for fever/HTN/hypercalcemia/weight loss/polycythemia/left varicocele; early radical nephrectomy with adrenal/lymph node/upper ureter removal and tumor thrombectomy. Tertiary: supportive care, transfusion, TPN, palliative nephrectomy/embolization for cachexia, bleeding, pain.

Recommended Department

It is recommended to visit the oncological surgery department; before the visit you may first book an appointment and connect with experts through this platform.

Warm reminder: The above information is provided for health education reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek care at a regular hospital in time.