Renal cell carcinoma

Alternative names:

adenocarcinoma of renal cells; cancer of the kidney; hypernephroma; kidney cancer; renal cancer

Symptoms:

• blood in the urine
• abnormal urine color (urine dark, rusty or brown colored)
• flank pain
• back pain
• abdominal pain
• weight loss, more than 5% of body weight
• emaciated, thin, malnourished appearance
• enlargement of one testicle
• swelling or enlargement of the abdomen

Additional symptoms that may be associated with this disease:

• vision abnormalities
• paleness
• hair, excessive on females
• constipation
• cold intolerance

Signs and tests:

Palpation of the abdomen may show a mass or organ enlargement, particularly of the kidney or liver. There may be a testicular varicocele.

• A CBC may show increased red blood cells (RBC) caused by stimulation of RBC production by the tumor. More commonly, though, it shows a decrease in RBC count.
• The RBC; urine is increased.
• Serum calcium levels may increase because of hormonal changes resulting from the tumor.
• The SGPT and alkaline phosphatase may be elevated.
• A urine cytology examination may show carcinoma cells.
• Liver function tests may show involvement of the liver from metastasis, or may be abnormal without metastasis.
• An ultrasound of the abdomen and kidney may show the tumor.
• Kidney X-ray may indicate a tumor or calcification.
• IVP may indicate obstruction by the tumor.
• Renal arteriography may show the tumor if it is highly vascular.

Because metastasis is common, the following tests to look for metastasis may be performed:

• An abdominal CT scan shows the kidney tumor and may show a liver mass.
• A chest X-ray may show mass in the chest.
• A bone scan may show involvement of the bones.