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Renal cell carcinoma: Difference between revisions
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<section begin="pathology" /><section begin="radiology" />'''Renal cell carcinoma''' (RCC) is the most common histological type of '''renal cancer''' in adults, accounting for 80+%. It's a malignant epithelial tumor that arises from the kidney tubules. It's usually discovered incidentally. When symptomatic, it usually presents with a classic triad of haematuria (with normal and not dysmorphic RBCs), costovertebral pain and/or a palpable mass in the flank. | <section begin="oncology" /><section begin="pathology" /><section begin="radiology" />'''Renal cell carcinoma''' (RCC) is the most common histological type of '''renal cancer''' in adults, accounting for 80+%. It's a malignant epithelial tumor that arises from the kidney tubules. It's usually discovered incidentally. When symptomatic, it usually presents with a classic triad of haematuria (with normal and not dysmorphic RBCs), costovertebral pain and/or a palpable mass in the flank. | ||
It's a relatively rare malignancy, with an incidence of 15/100 000 new cases every year. It's mostly a disease of elderly men. Most are diagnosed with localised disease. Up to 70% of cases are incidentally diagnosed on imaging.<section end="radiology" /> | It's a relatively rare malignancy, with an incidence of 15/100 000 new cases every year. It's mostly a disease of elderly men. Most are diagnosed with localised disease. Up to 70% of cases are incidentally diagnosed on imaging.<section end="radiology" /> | ||
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== Pathology == | == Pathology == | ||
Renal cell carcinomas are adenocarcinomas which arise from the tubular epithelium. The most common types are clear cell carcinoma (80%+ of cases) and papillary carcinoma (10% of cases). Other types include: | Renal cell carcinomas are adenocarcinomas which arise from the tubular epithelium. The most common types are clear cell carcinoma (80%+ of cases) and papillary carcinoma (10% of cases). <section end="oncology" />Other types include: | ||
* Chromophobe RCC – 5% of cases | * Chromophobe RCC – 5% of cases | ||
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Collecting duct RCC is a very rare subtype. It’s very aggressive and has a particularly bad prognosis. | Collecting duct RCC is a very rare subtype. It’s very aggressive and has a particularly bad prognosis. | ||
<section begin="oncology" /> | |||
=== Grading === | === Grading === | ||
The Furhman system is used as grading system for kidney tumors. It’s based mostly on how prominent the nucleoli are – the more prominent, the higher the grade. A grade IV RCC has ''sarcomatoid'' or ''rhabdoid'' appearance. | The Furhman system is used as grading system for kidney tumors. It’s based mostly on how prominent the nucleoli are – the more prominent, the higher the grade. A grade IV RCC has ''sarcomatoid'' or ''rhabdoid'' appearance. | ||
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=== Targeted therapy === | === Targeted therapy === | ||
[[Category:Oncology]] | Targeted therapy may be combined with immune checkpoint inhibitors for palliative therapy of metastatic RCC. These are tyrosine kinase inhibitors like cabozanitinib, sunitinib, or lenvatinib.<section end="oncology" />[[Category:Oncology]] | ||
[[Category:Urology]] | [[Category:Urology]] | ||