Kidney cancer

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I. Etiologiyai prevalence

  • Morbidity

Kidney cancer is 3% of malignant tumors in adults. Men get sick twice as often as women. Most cases occur in age from 30 to 70 years

  • Etiology.
  • The cause of kidney cancer risk neizvestna.Faktory
    • Smoking (heavy smokers the risk increased 2.3-fold).
    • Urban lifestyle.
    • Kidney cancer in relatives.
    • The introduction of Thorotrast.
    • Hereditary syndromes.
  • Possible risk factors include polycystic kidney disease, diabetes mellitus and chronic hemodialysis.

I I. Pathological anatomy and flow

  • Renal cell carcinoma. Kidney cancer (adenocarcinoma, renal cell carcinoma, hypernephroma, tumor Gravittsa) is nearly all cases of malignant renal tumors in adults. Usually the tumor is round and surrounded by a false capsule consisting of connective tissue and parenchyma squeezed. In 2% of cases both kidneys are affected (synchronous or metachronous).
    • Distinguish clear cell carcinoma, hromofilny (papillary) carcinoma, chromophobe carcinoma, carcinoma of the collecting tubules and ungraded cancer. In each case the possible solid tumor growth forecast which is significantly worse than in the alveolar and tubulopapillyarnom growth.
    • Clear cell carcinoma based on the proximal renal tubules. The tumor invades surrounding structures, and often spreads to the renal vein, gives lymphogenous and hematogenous metastasis (usually to the lungs, liver, bones and brain). The first manifestation of renal cell carcinoma metastases are an unusual location - in the fingertip, eyelid, nose, characteristic histological picture indicates a diagnosis.
    • During kidney cancer is less predictable than most solid tumors. The primary tumor may grow at different rates and sometimes for many years remains localized. Metastatic growth can slow down for a long time and seemed to stop, sometimes they are found, many years after resection of primary tumor.
  • Renal pelvis cancer. Renal pelvis carcinoma (cancer perehodnokletochny) - a rare tumor. At the same time may be affected by other divisions of the urinary tract - the ureters and bladder. Usually vysokodifferentsiron tumor, but is detected at a late stage. Sometimes there is a kind of creeping growth of the tumor on retroperitoneal space with compression of blood vessels and ureters. Hematogenous metastases are possible, usually in the lungs and bones. 
  • Rare tumors
    • Nephroblastoma (Wilms tumor) - a tumor that occurs in children and usually attains a large size, in adults it is rare.
    • Lymphoma and sarcoma kidney downstream reminiscent of similar tumors of other organs of the abdominal cavity.
    • Tumor of juxtaglomerular cells (reninoma) is usually benign and secretes renin, this is a rare cause of hypertension.
    • Hemangiopericytoma is malignant in 15% of cases, it also secretes renin, causing severe hypertension.

  I   I   I. Diagnosis

  • The clinical picture.

There are no complaints, except for hematuria, usually talking about a large, advanced tumors. Classic Trial - pain, hematuria and volume formation in the side of the abdomen - is less than 10% of patients. Occasionally, in renal cell carcinoma shows a combination of hematuria with anemia and fever. Widespread use of ultrasound, CT and PT M changed the clinical picture of renal cancer: two-thirds of localized tumors detected by accident, so many patients at the time of diagnosis, no matter what do not complain.

  • Complaints
    • Gross hematuria is approximately 40% of patients.
    • Constant dull pain in the side of the abdomen occurs with the same frequency (40%). Theres also a sharp pain during the passage of blood clots in the ureter.
    • To complain about weight loss of about 35% of patients.
    • The sudden appearance of a varicocele on the right or left - a rare complaint, usually associated with thrombosis, respectively, the left renal vein and inferior vena cava.
    • Swelling of the legs - a sign of locally advanced process obstruction of veins and lymph vessels.
    • Fever, pletora, manifestations of hypercalcemia and anemii also are the first signs of kidney cancer.
  • Prevention and early diagnosis.

Prevention of kidney cancer may contribute to the fight against smoking. Early diagnosis is dependent on timely survey on hematuria and other suspicious symptoms.

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