Renal cell carcinoma is the most common cancer of the kidney, comprising about 75 per cent of the renal cancers. It is also known as hypernephroma and Grawitz tumour. Renal cell carcinoma usually occurs during the age of 50 to 60 years. The incidence is twofold higher in males as compared to females. It mostly affects the people living in urban and industrialised areas. Renal cell carcinoma is an adenocarcinoma, usually arising from the cells of proximal tubules in the renal cortex. The exact cause of renal cell carcinoma is not fully understood. Researchers believe that smoking is linked to about 30 per cent cases of the renal cell carcinoma. It has been observed that the workers of rubber, leather, petroleum, textile, dye, insulation and plastic industries are more likely to develop renal cell carcinoma. Risk factors include obesity and exposure to radiation & chemical carcinogens that might have been inhaled, ingested or produced within the body. Prolonged abuse of analgesics may lead to renal cell carcinoma.
Patients suffering from renal cell carcinoma usually, remain asymptomatic in the early stages of the disease. In advanced stages of the renal cell carcinoma, there may be haematuria (gross or microscopic), pain in the flanks and palpable renal mass. These three signs are collectively known as a classical triad. Other symptoms of renal cell carcinoma include fever (without infection), nausea, vomiting, loss of appetite, loss of weight, malaise, lassitude and anaemia. There may be endocrine disturbances, polycythaemia, hypertension, nephrotic syndrome and hypercalcaemia. Varicocele may occur due to occlusion of the renal and the testicular veins. There may be occlusion of the inferior vena cava leading to oedema in the legs. Renal cell carcinoma usually metastasises to the lungs, bones and the para-aortic lymph nodes.
Staging of the renal cell carcinoma is done as follows:
Procedures used in diagnosis and evaluation of the renal cell carcinoma include urine analysis, intravenous pyelography (IVP), intravenous urogram (IVU), renal arteriography, ultrasound, CT scan, MRI and biopsy.
Nephroblastoma (Wilm's tumour) is the second most common cancer of the kidney. It is a fast-growing tumour that usually affects young children during the first decade, especially in the first year of life. Nephroblastoma comprises about 8 per cent of the childhood tumours. It affects boys and girls equally. The exact cause of nephroblastoma is not fully understood. It has been observed that about 10 per cent cases of the nephroblastoma have some kind of congenital abnormality. Researchers believe that there are hereditary and non-hereditary types of nephroblastoma. The hereditary nephroblastoma occurs in younger children and usually affects both the kidneys. The most common symptom of nephroblastoma is a mass in the abdomen. Other symptoms include low-grade fever, loss of appetite, loss of weight, pallor, lethargy and haematuria. Nephroblastoma usually metastasises to the liver, lungs and the bones.
Staging of the nephroblastoma is done as follows:
Procedures used in the diagnosis and evaluation of nephroblastoma include urine analysis, IVP, ureteropyeloscopy, selective renal arteriography, ultrasound, CT scan, MRI and biopsy.
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