Kidney Cancer / Renal Masses

Tumors of the kidneys can be benign or malignant. The vast majority are discovered as incidental findings on a CT scan of the abdomen that is performed for reasons other than assessing kidney health. In fact, the overwhelming majority of kidney tumors, both benign and malignant, are found when they are essentially asymptomatic. If a kidney tumor does grow undetected it can become symptomatic. Symptoms common to kidney tumors are blood in the urine (visible or microscopic), an abdominal mass in thin patients, flank pain and weight loss.

Once a kidney tumor is detected additional radiographic studies might be requested to further characterize the tumor. Ultrasound, CT scan with and without intravenous contrast, MRI, PET scan and angiography (a dye study of the vessels carrying blood to the tumor) can provide valuable information about the size of the tumor and its relationship to the rest of the kidney and nearby organs. Despite the availability of these studies there is sometimes the need for needle biopsy of the tumor to decipher whether it is benign or malignant. On occasion, multiple kidney tumors are identified and can involve both kidneys simultaneously.

The most common benign tumors that affect the kidneys are renal adenomas, oncocytomas and angiomyolipomas. Although these tumors do not spread (metastasize) to other organs and pose no serious threat to the well-being of those people known to have them, they must sometimes be removed if they grow too large as they can cause internal hemorrhaging.

Most malignant kidney tumors are renal cell carcinomas, also referred to as adenocarcinomas. 35,000 people are diagnosed with renal cell carcinoma in the United States each year. Men are more likely than women to get renal cell carcinoma and people in their mid-forties to mid-sixties are at greatest risk for the disease. Rarely is renal cell carcinoma an inherited kidney cancer. Most cases are considered to be due to a sporadic mutation. Approximately 15 to 20% of people found to have renal cell carcinoma have some form of spread of the disease when first diagnosed. The lungs are the most common site of spread. Renal cell carcinoma also tends to metastasize to the adrenal gland, the brain, the bones, the liver and the opposite kidney.

Kidney Cancer Treatment Options

Treatment of renal cell carcinoma entails surgical removal of the tumor and sometimes necessitates removal of the entire involved kidney. Radiation therapy and chemotherapy are reserved for cases of advanced disease where cure of the kidney cancer is no longer the focus of treatment, but where an attempt is made at slowing the further spread of disease. Surgery, which is typically performed through an open incision or using a robotic-assisted laparoscopic approach, is completed under a general anesthetic and is associated with a short hospital stay. Occasionally, small renal cell carcinomas can be treated using percutaneous techniques that utilize high-frequency ultrasound waves or cryosurgery (freezing the tumor). Angioinfarction (cutting off the blood supply to the tumor) is a minimally invasive means of managing renal cell carcinoma in patients who are not healthy enough to undergo surgery.

When a kidney tumor is discovered a consultation in the office is advised. Radiographic imaging studies can be reviewed and an individualized treatment plan can be formulated. When recognized early and treated successfully, surgical cure rates from renal cell carcinoma exceed 90%.


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