Kidney tumor

Kidney tumor. The kidney tumor forms in the membrane that lines the tiny tubes inside the kidneys. It occurs when cells in either the kidney cortex or the renal pelvis grow uncontrollably and form tumors that can invade normal tissues and spread to other parts of the body.

Summary

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  • 1 Causes
  • 2 Symptoms
    • 1 The most common symptoms of this type of cancer are listed below (although it is clear that each individual may experience them differently)
  • 3 Risk factors
  • 4 Tests and reviews
    • 1 In addition to the physical examination, the following tests may be used
  • 5 General characteristics
  • 6 Benign tumors
    • 1 Reninoma
    • 2 Oncocytoma
    • 3 Angiomyolipoma
  • 7 Forecast
  • 8 Diagnosis
    • 1 Laboratory tests
    • 2 Intravenous urography
    • 3 Renal angiography (also called arteriography)
    • 4 Computed tomography (_scanner_ or TAC)
    • 5 Magnetic resonance imaging (NMR)
    • 6 Ultrasound
    • 7 Biopsy
  • 9 Treatment
    • 1 Extended nephrectomy
    • 2 Partial nephrectomy
    • 3 Arterial embolization
    • 4 Radiotherapy
    • 5 Chemotherapy
    • 6 Immunotherapy
  • 10 After treatment
  • 11 Field of treatment
  • 12 Related Links
  • 13 Sources

Causes

Today, the causes of kidney cancer are still not well understood. Despite this, although it is not known exactly why this cancer develops, certain behaviors, habits and actions have been discovered that increase a person’s chances of developing it, although it has been related to certain genetic diseases and tobacco use. .

symptom

In the early stages of the disease, there may not be any symptoms. These can appear as the tumor grows.

The most common symptoms of this type of cancer are listed below (although it is worth noting that each individual can experience them in a different way)

  • Blood in the urine.
  • Rapid and unexplained weight loss.
  • Pain in the lower back (not due to injury).
  • Loss of appetite
  • Swelling of the ankles and legs.
  • Mass or lump in the abdomen.
  • Recurrent fever (not due to a cold or the flu).
  • High blood pressure (less frequent).
  • Anemia (less frequent).
  • Constant pain on one side, which does not go away.
  • Recurrent fever (fever from another cause not related to a cold, flu, or other infection)
  • In men, the rapid development of a varicocele (a group of enlarged veins) around the testicle

Symptoms can come on suddenly. However, as with other cancers, kidney cancer can cause a general feeling of ill health. People suffering from this disease can feel weak, tired, without appetite, etc. Others may lose weight. Or having febrile processes that appear and disappear … However, all these symptoms can also be due to other less serious diseases, so in any case, you should go to a urologist for a definitive diagnosis.

Risk factor’s

The consumption of foods rich in fats and cholesterol, environmental carcinogens and tobacco. A higher incidence of kidney cancer has been observed in people with kidney failure, depending directly on how long they have been on dialysis. Other important risk factors for the development of kidney cancer are related to your family history. Obviously, no one can change the family into which they were born, so the risk factor of having someone in the family with a history of kidney cancer or rare genetic diseases such as Von Hippel-Lindau disease and polycystic disease it cannot be prevented.

Tests and exams

There are no early screenings for kidney cancer that are similar to mammography for breast cancer or colonoscopy for colorectal cancer. However, the use of CT scanning and ultrasound have increased early detection of kidney cancer once the signs and symptoms have developed. Intravenous pyelograms (PIVs) are used to assess kidney function. PIVs are made by injecting a dye into a patient’s arm and then taking x-rays of the abdomen to see that dye being subsequently excreted by the kidneys as urine. Cytology is simply looking at the urine under a microscope and looking for cancer cells in the urine. Because they can cause early symptoms that lead to tests,ultrasound , 25-40% of kidney cancers are now detected incidentally during follow-up for some different problem. These tumors are more likely to be smaller (so they do not cause symptoms) and thus are more likely to result in a cure.

In addition to the physical exam, the following tests may be used

  • Analysis of bloodand urine

You can have a blood test to check the number of red blood cells and a urine test to detect the presence of blood, bacteria, or cancer cells. These tests may suggest the presence of kidney cancer, but do not allow a definitive diagnosis to be made.

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General characteristics

Kidney tumors can have two origins. One group of tumors originates from the portion of the kidney that is responsible for forming urine and is called the parenchyma. The other group of tumors originates from what is called the excretory system, which is the part of the kidney that has the function of lead urine from the kidney to the ureter and through it to the bladder . Tumors that arise in the renal parenchyma represent 3% of all malignant tumors in the body and within the genitourinary system, third place, behind prostate and bladder cancers. Despite this, its frequency is increasing based on two factors; On the one hand, the widespread use of imaging studies such as ultrasound and computed tomography allows incidental or incidental finding of tumors, that is, those with no clinical manifestations. The other factor that increases the frequency of this disease is increasing the life expectancy of the population.

The renal tumor occurs more frequently at an age between 55 and 65 years, however, the appearance of cases in patients younger than 40 years is increasingly noticeable. It is more frequent in men than in women. Kidney tumors can be benign or malignant, more malignant than benign tumors are diagnosed. (80% vs. 20%). The classic and most frequent malignant tumor is clear cell carcinoma with various degrees of malignancy. The most frequent benign tumors are adenomas, oncocytomas and angiomyolipomas. Adenomas exceptionally give symptoms and are not large enough to be detected by studies and often go untreated. When it is certain, with previous studies, that it is benign tumors, they can be controlled without the need for treatment, only theAngiomyolipoma should be treated when it reaches a certain size because it has the possibility of rupturing its vessels and causing severe bleeding, so the reason for operating them is not due to a malignant potential, but because of the risk of acute bleeding .

Benign tumors

The benign tumors of the kidney are relatively common, especially in atrophic kidneys of adults and the elderly. They are generally very small, a few millimeters in diameter, and are usually found as autopsy findings, since they have no clinical manifestations. These include fibroids of the renal medulla and cortex, which are found in 10 to 35% of autopsies, and cortical adenomas, which are seen in 20% of necropsies. Adenomas are benign renal cell tumors, They can be tubular or papillary. When they are larger, more than 3 cm in diameter, they are difficult to differentiate from renal cell carcinomas and in this case they are considered tumors of uncertain biological behavior.

Reninoma

It is a juxtaglomerular apparatus tumor made up of renin-producing cells. This substance can be identified with immunohistochemical techniques and with electron microscopy. It is generally not a large tumor and clinically manifests with hypertension.

Oncocytoma

It is a renal cell tumor made up of oncocytes (cells rich in mitochondria). This tumor can be large in size and resemble a renal cell carcinoma.

Angiomyolipoma

This tumor belongs to the group of hamartomas. It is made up of mature adipose tissue, blood vessels without elastic fibers and bundles of smooth muscle fibers. Its size is variable, it can reach 20 cm in diameter. In 80% of cases it is associated with tuberous brain sclerosis (Bourneville disease). It is observed more frequently in the female sex between 40 and 50 years of age. Clinically it is manifested by pain, fever, hematuria, and high blood pressure.

Forecast

The prognosis of this disease depends fundamentally on the size of the tumor at the time the diagnosis is made and on the intrinsic aggressiveness of these lesions. For small and incidentally found tumors, cure rates may be close to 100%.

In summary, we could say that they are tumors that usually appear between 55 and 65 years old, predominate in males, with a varied form of presentation and a high rate of cases without symptoms.

They usually do not present with multiple metastases. Ultrasonography and computed tomography have a high sensitivity index for diagnosis. Clear cell renal carcinoma is the most frequent variety. Surgery represents the only treatment with the possibility of offering a cure. Conservative kidney surgery can be performed on small, asymptomatic tumors. The prognosis depends on the extent and degree of malignancy of the tumor.

Diagnosis

The clinical presentation of kidney cancer is highly variable. Currently, 40 to 50 percent of kidney tumors are diagnosed by ultrasound during a routine medical examination, when the tumor has not yet caused any symptoms.

At other times, they are diagnosed after visiting the patient who has the clinical symptoms that the tumor may cause. In addition to a physical exam and a complete medical history, procedures to diagnose kidney cancer may include the following:

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Laboratory exams

Intravenous urography

  • This is a series of x-rays of the kidneys, ureters, and bladder after a contrast dye is injected into the vein to detect tumorsabnormalities , kidney stones, or any obstructions, and to evaluate renal blood flow .

Renal angiography (also called arteriography)

  • It consists of a series of X-raysof the renal blood vessels after a contrast medium is injected through a catheter placed into the renal blood vessels to detect any signs of blockage or abnormalities affecting the blood supply to the kidneys.

Computed tomography (_scanner_ or TAC)

  • It is a non-invasive procedure that takes pictures of cross sections of the brain or other internal organs to detect abnormalities that may not appear on regular X-rays.

Magnetic resonance imaging (NMR)

  • It is a non-invasive procedure that produces two-dimensional views of an internal organ or structure, especially the brainor spinal cord .

Ultrasound

  • It is an imagingtechnique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs . Ultrasound is used to see the function of the internal organs and to assess the flow of blood through various vessels.

Biopsy

  • The biopsyis a procedure in which a sample of the tumor is obtained and sent to the laboratory for examination by a pathologist . Biopsy is the only sure way to diagnose cancer before surgery, but its usefulness is limited, since it is often inconclusive (if cancer is not found on biopsy, but imaging tests suggest it is cancer, it will have to be operated anyway).

Treatment

  • Surgery is the standard treatment for localized tumors where cure of the disease is possible in more than 50% of cases.

In advanced stages surgery can help to alleviate the symptoms caused by the tumor and in some patients with few metastases, a greater survival can be obtained if the tumor and metastases are excised . Currently, the treatment of choice for kidney cancer is expanded nephrectomy .

Extended nephrectomy

  • In this intervention, the entire kidney is removed along with the fat that surrounds it and the lymph nodes adjacent to the area of ​​the vessels that supply the kidney. In tumors affecting the upper pole of the kidney, the removal of the adrenal gland is included.Due to the improvement in early diagnosis techniques that allow the detection of smaller tumors, treatment can be modified by performing a partial nephrectomy.

Partial nephrectomy

  • With this technique, only the portion of the kidney in which the tumor is found is removed, keeping the rest of the healthy kidney. The partial nephrectomyis done when it comes to tumor whose size is not more than 4.5 cm in diameter and are located in areas of the kidney where they are not affected or may be committed to the blood vessels that nourish the kidney.

Approximately 25% of kidney cancer patients already metastasize at the time of diagnosis.

Arterial embolization

  • If the tumor is localized but cannot be operated, you can try to alleviate the symptoms caused by radiation therapy or by selective obstruction of the blood vessels that support it.

Radiotherapy

  • Radiation therapy can help alleviate symptoms caused by the primary tumor ( painbleeding ) or metastases (for example, pain from bone or nerve involvement).

Chemotherapy

  • Conventional chemotherapy has not been very successful in treating metastatic renal cell carcinoma.

Immunotherapy

  • Immunotherapy is a treatment that stimulates the immune system to fight the tumor, using special substances: interferonor interleukin . These treatments may alleviate symptoms and have a modest survival benefit, especially if the kidney is removed prior to treatment. Anti-angiogenic drugs have shown very promising efficacy in metastatic kidney tumors .

The Sorafenib , was the first drug of this family recently marketed for the treatment of kidney cancer. Other drugs such as Sunitinib (Sutent ®) and Bevacizumab have also been shown to be active. Transitional cell carcinomas are generally treated by surgery to remove the entire kidney and ureter , as well as the part of the bladder where it binds the ureter. Chemotherapy and radiation are often used in addition to surgery .

After treatment

After treatment for kidney cancer, it is very important to follow up regularly to check the patient’s condition. These regular medical examinations will detect and treat any problems that may have reoccurred. Controls may include tests, x-rays, or laboratory testsDiagnosing kidney cancer can change the lives of the patient and the people around him and who care for them. These changes can be difficult to take on and bear. It is very common for family and friends to have different and confused emotions about the patient, and some days patients and those around them may feel fear, anger, depression, etc. These types of reactions are normal when one faces a serious health problem. Other people in the same situation have realized that they can cope better with their situation if they are able to speak openly with their family or friends.

Sharing feelings can help you feel better and can help others show your support and concern. Loss of appetite is a serious problem during and after cancer treatment. In fact, patients who continue to eat well tend to endure the effects of treatment better. This means that maintaining good nutrition is an important part of treatment. It is usually easier and more advantageous to eat several times throughout the day in small amounts than to eat only three meals.

Treatment field

Scientists , hospitals and universities are studying this disease worldwide. What is attempted is to learn what are the real causes of kidney cancer and how to prevent it. In addition, better ways to prevent and treat it are sought. What is to be improved are the techniques to detect it in the early stages of the disease, before it has begun to spread. For example, certain substances that are present in abnormal amounts in the blood or urine of people with this type of cancer are being studied.

 

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