Renal cell carcinomaA CT scan showing bilateral renal cell carcinomas
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Renal cell carcinoma

Renal cell carcinoma, also known by the eponym Grawitz tumor, is the most common form of kidney cancer arising from the renal tubule. It is the most common type of kidney cancer in adults. Initial therapy is with surgery. more...

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

Signs and symptoms

The classic triad is hematuria (blood in the urine), flank pain and an abdominal mass. This "classic triad" is infrequently present when the patient first presents for medical attention.

Other signs may include:

  • Abnormal urine color (dark, rusty, or brown) due to blood in the urine
  • Weight loss of more than 5% of body weight with emaciated, thin, malnourished appearance
  • More and more frequently, renal cell carcinoma is identified as an incidental finding on a medical imaging study of the abdomen (e.g. computed tomography a.k.a. CT) done for an unrelated purpose
  • The presenting symptom may be due to to metastatic disease, such as a pathologic fracture of the hip due to a metastasis to the bone
  • Enlargement of one testicle (usually the left, due to blockage of the left gonadal vein by tumor invasion of the left renal vein -- the right gonadal vein drains directly into the inferior vena cava)
  • Paraneoplastic phenomena (not directly due to the mass, but due to secreted substances with hormonal activity):
    • Vision abnormalities
    • Pallor or plethora
    • Excessive hair growth (females)
    • Constipation
    • Cold intolerance
  • High blood pressure


Renal cell carcinoma affects about three in 10,000 people, resulting in about 31,000 new cases in the US per year. Every year, about 12,000 people in the US die from renal cell carcinoma. It is more common in men than women, usually affecting men older than 55.

Why the cells become cancerous is not known. A history of smoking greatly increases the risk for developing renal cell carcinoma. Some people may also have inherited an increased risk to develop renal cell carcinoma, and a family history of kidney cancer increases the risk.

People with von Hippel-Lindau disease, a hereditary disease that also affects the capillaries of the brain, commonly also develop renal cell carcinoma. Kidney disorders that require dialysis for treatment also increase the risk for developing renal cell carcinoma.


Gross examination shows a hypervascular lesion in the renal cortex, which is frequently multilobulated, yellow (because of the lipid accumulation) and calcified.

Light microscopy shows tumor cells forming cords, papillae, tubules or nests, and are atypical, polygonal and large. Because these cells accumulate glycogen and lipids, their cytoplasm appear "clear", lipid-laden, the nuclei remain in the middle of the cells, and the cellular membrane is evident. Some cells may be smaller, with eosinophilic cytoplasm, resembling normal tubular cells. The stroma is reduced, but well vascularized. The tumor grows in large front, compressing the surrounding parenchyma, producing a pseudocapsule.


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A case of renal cell carcinoma metastatic to the nose and tongue - Original Article
Abstract Reported cases of renal cell carcinoma metastatic to the nose or to the tongue are rare. No case of renal cell carcinoma metastatic to both ...
A rare case of renal cell carcinoma metastatic to the sinonasal area
Abstract We report a rare case of a hypernephroma that had metastasized to the sinonasal area as a solitary mass. Despite much difficulty, a confirmatory ...
The presentation, treatment and outcome of renal cell carcinoma in old age - Statistical Data Included
Objective: to review clinical presentation and outcome of patients with a diagnosis of renal cell carcinoma at a district general hospital and assess ...
Risk factors for renal cell carcinoma in women
The incidence of kidney cancer in the US has increased in recent years. Most kidney cancers are renal cell carcinomas. The risk factors for this type of cancer are poorly understood, but may include
Sarcomatoid Renal Cell Carcinoma With Divergent Sarcomatoid Growth Patterns: A Case Report and Review of the Literature
A 71-year-old woman who presented with left abdominal pain was found to have a noncalcified renal mass with a perisplenic extension on imaging studies.
Dietary factors and renal cell carcinoma - adapted from the European Journal of Cancer, April 1996
Known risk factors for renal cell carcinoma include cigarette smoking, history of hypertension and use of diuretics, occupational exposure to hydrocarbons, ...
Primary Renal Synovial Sarcoma Confirmed by Cytogenetic Analysis: A Lesion Distinct From Sarcomatoid Renal Cell Carcinoma
Primary synovial sarcoma rarely originates in the renal parenchyma. When this occurs, origin of this unusual tumor type has been the subject of debate ...
Clear Cell Renal Cell Carcinoma With Syncytial Giant Cells: A case Report and Review of the Literature
Renal cell carcinoma with syncytial giant cells (SGCs) is rare; to our knowledge, there are only 3 cases reported in the English literature. We report ...

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