Clinical Presentation - Renal Cancer

  • "Classic triad": flank pain, a palpable mass, and hematuria is now seen in less than 10% of patients.
  • Hematuria (gross or microscopic) seen most often among the classic symptoms
  • Increasing number of lesions (>25%) are seen as incidental findings on imaging for other conditions
  • Systemic syndromes
    • Anemia, fatigue, cachexia, weight loss 20-40%
    • Hypercalcemia 10-15 %
    • Hepatic dysfunction (Stauffer's syndrome) 5%
    • Rare syndromes: Erthrocytosis, protein wasting enteropathy, neuomyopathy, amyloidosis

References

  • Bostwick DG, Eble JN: Diagnosis and classification of renal cell carcinoma. Urol Clin N Am 26:627-635, 1999.
  • Caddeddu JA, Ono Y, Clayman RV, et al: Laparoscopic nephrectomy for renal cell cancer: Evaluation of efficacy and safety: A multicenter experience. Urology 52:773-777, 1998.
  • Levy DA, Slaton JW, Swanson DA, Dinney CP: Stage specific guidelines for surveillance after radical nephrectomy for local renal cell carcinoma. J Urol 15:1163-1167, 1998.
  • Montie JM: Lymphadenectomy for renal cell carcinoma. Semin Urol 7:181-185, 1989.
  • Motzer RJ, Bander NH, Nanus DM: Renal-cell carcinoma. N Engl J Med 335:865-875, 1996.
  • Novick AC: Renal-sparing surgery for renal cell carcinoma. Urol Clin North Am 20:277-282, 1993.
  • Sagalowsky AI, Kadesky KT, Ewalt DM, Kennedy TJ: Factors influencing adrenal metastasis in renal cell carcinoma. J Urol 151:1181-1184, 1994.
  • Skinner DG, Pritchett RT, Lieskovsky G, Boyd SD, Stiles QR: Vena caval involvement by renal cell carcinoma. Surgical resection provides meaningful long-term survival. Ann Surg 210:387-394, 1989.
  • Sufrin G, Cashon S, Golio A, Murphy GP: Paraneoplastic and serologic syndromes of renal adenocarcinoma. Semin Urol 7:158-171, 1989.
  • Yang JC, Topalian SL, Parkinson D, et al: Randomized comparison of high-dose and low-dose intravenous interleukin 2 for the therapy of metastatic renal cell carcinoma: An interim report. J Clin Oncol 12:1572-1576, 1994.