KIDNEY URETER Tumours renal cell

10. TUMOURS Fig.25.11a+b+c

10.1  Transitional Cell Carcinoma of the renal pelvis  constitute

5%  of  all renal carcinoma and present with  pain  and  symptoms

similar to renal stone disease. Hematuria may also be a prominent

symptom. Treatment is with a nephrectomy. Fig.25.10a.

10.2   Renal   Adenocarcinoma  (Hypernephroma,   grawitz   tumor)

Fig.25.10b

The  most  common malignancy involving the  kidney,  occurs  most

often  in  the  fifth decade of life. Incidence  is  three  times

higher  in  males  than in females. There are  three  cell  types

identified in these tumours:

*  Clear  cells,  large polyhderal cells,  clear  to  light  with

   vaculated cytoplasm

*  Spindle-shaped  cells,   arranged  in  papillary  or   tubular

   structure

*  Granular cells, smaller than clear cells.

SIGNS AND SYMPTOMS

Renal  carcinoma may present with a variety of symptoms  patterns

(Table 25.1). Hypertension occurs in 14 to 40% of patients.

TREATMENT

The  treatment of renal cell carcinoma confined to the kidney  is

surgery.

Surgery  is  not  effective  once the  disease  has  extended  to

adjacent  structures.  When the tumour is confined to  the  renal

substance beneath the capsule itself, survival rates greater than

ninety percent in 10 years can be expected.

The operative approach to renal tumour may be through the  flank,

chest  or  abdomen.  Removal of the  perinephric  fat  and  local

lymphnodes with the kidney provides the best results. Removal  of

primary   renal   tumour  has  been  observed  to   be   followed

occasionally by regression of metastases.

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