Renal pelvis tumors

ALSO KNOWN AS: Gurnistical tumors

RELATED CONDITIONS: Renal cell carcinomas, kidney cancer

DEFINITION: Renal pelvis tumors are masses that develop in the center of the kidney and can become malignant (cancerous).

Risk factors: Risk factors for renal tumors include smoking, misusing certain pain medicines over an extended period, and having certain genetic conditions, such as von Hippel-Lindau disease or hereditary papillary renal cell carcinoma.

Etiology and the disease process: Renal pelvis tumors develop in the kidney tubule (or renal tubule), which is the kidney's portion constituting the kidney's basic filtration unit.

Incidence: Renal pelvis tumors affect approximately 1.8 percent of the population, with approximately 81,800 cases diagnosed in 2023. The average age of diagnosis was sixty-five, with most patients between the ages of fifty-five and sixty-nine.

Symptoms: Symptoms of renal pelvis tumors include blood in the urine, a noticeable lump in the abdomen, pain in the side or back, weight loss, and anemia.

Screening and diagnosis: Diagnosis of renal pelvis tumors is confirmed with a physical exam, urinalysis, and urine cytology tests. The urinalysis determines if abnormalities, such as blood, protein, sugar, and solids, exist in the urine. Urine cytology is a microscopic examination of urine to detect any abnormal cells that have sloughed off the bladder or kidney walls and been released in the urine. If necessary, a cytoscopy is performed with a very narrow tube with a light and camera inserted through the urethra to examine the inside of the bladder and ureter. Ureteroscopic techniques allows for endoscopic access, which allows doctors to more accurately diagnose and stage cancers. Further imaging studies can help determine if the cancer has spread to other layers of the organs or beyond the urinary tract. Tumors found in the collecting duct are transitional or medullary carcinomas.

If bladder or kidney cancer is suspected, a physician may order a computed tomography (CT) scan, pyelography, or biopsy. The CT scan provides a three-dimensional view of the urinary tract to determine whether any masses or tumors exist. Pyelography involves injecting a special dye into the vein or urethra and examining a series of X-rays to determine if abnormalities exist. The biopsy is typically performed during cytoscopy, and abnormal cells can be detected with a microscope.

The staging of the disease, according to the National Cancer Institute, is as follows:

• Stage I: The tumor is 7 centimeters (cm) or smaller and is found only in the kidney.
• Stage II: The tumor is larger than 7 cm and is found only in the kidney.
• Stage III: Cancer is found in the kidney and in one nearby lymph node, in an adrenal gland, in the layer of fatty tissue around the kidney, or in the main blood vessels of the kidney, and it may also be found in one nearby lymph node.
• Stage IV: Cancer has spread beyond the layer of fatty tissue around the kidney and may be found in one nearby lymph node; or to two or more nearby lymph nodes; or to other organs, such as the bowel, pancreas, or lungs, and may be found in nearby lymph nodes.

Treatment and therapy: Renal pelvis tumors that are noncancerous can be closely monitored for an increase in size or for malignant development. If necessary, they can be removed with surgery. Malignant renal tumors do not respond to chemotherapy or radiation therapy, and therefore, surgery is required to remove the cancerous tumor.

Renal pelvis tumors are sometimes also treated with immunotherapy, which stimulates the patient’s immune system to recognize tumor cells as targets and attack the malignant tumor cells. This is accomplished by administering therapeutic antibodies to enable the immune system to destroy tumor cells.

Prognosis, prevention, and outcomes: The prognosis is excellent if renal pelvis tumors are treated early. However, because symptoms often go unnoticed, diagnosis is not usually made until the cancer is in later stages. The five-year survival rate for kidney and renal pelvis cancer in the United States is 76.6 percent. However, this number fluctuates depending on the stage of cancer diagnosed and several other patient-specific factors.

Bibliography

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