Урология - Tumors

Tumors

Renal tumors

Aethiology

There is no single reason

Smoking increases risk of having a kidney tumor

Occupation – coke oven workers, asbestos

Radiation exposure, therapy, thorotrast

Phenacetin

Von Hippel-Linday disease

Classification

Tumors of renal parencyma

Benigh: adenoma, lypoma, fibrioma, angioma and haemangioma, mixoma, dermoid

Malignant: nephrocellular cancer, fibro-, myo-, lypo-, angio-sarcoma, Wilm’s tumor

Secondary ( matestatic) tumor of kidney

Classification

Tumors of renal pelvis

Benigh: papilloma, angioma, leyoma

Malignant: transitional cell carcinoma, adenomucose carcinoma, squamose cell carcinoma, sarcoma.

Symptoms and clinic

General symptoms: loss of weight, worthening of general condition, elevation of ESR, erytrocytosis, arterial hypertension.

Local: haematuria at (30-70 %) of patients, palpable tumor, pain in lumbal area, varicocele.

Asymptomatic

Symtoms of metastatic affection of other organs

Lungs: picture of pnemonia or tuberculosis (miliar metastasis), or like bronchogenic cancer (solitary tumor)

Bones: intencieve pain, non stopping even after intake of narcotic analgetics, patologic fructures. Sometimes looks like radiculitis or neuralgia.

Diagnostics

Ultrasound

CT

Magnetic resonance tomography

Radioisotope nephroscintygraphy

Renal angiography (rarely)

Punction biopsy

TNM classification

Primary tumor (T)

TX - Primary tumor cannot be assessed

T0 - No evidence of primary tumor

T1 - Tumor 7 cm or smaller in greatest dimension, limited to the kidney

T2 - Tumor larger than 7 cm in greatest dimension, limited to the kidney

T3 - Tumor extends into major veins or invades adrenal gland or perinephric tissues but not beyond the Gerota fascia

T3a - Tumor invades adrenal gland or perinephric tissues but not beyond the Gerota fascia

T3b - Tumor grossly extends into the renal vein(s) or vena cava below the diaphragm

T3c - Tumor grossly extends into the renal vein(s) or vena cava above the diaphragm

T4 - Tumor invading beyond the Gerota fascia

TNM

Regional lymph nodes (N) - Laterality does not affect the N classification

NX - Regional lymph nodes cannot be assessed

N0 - No regional lymph node metastasis

N1 - Metastasis in a single regional lymph node

N2 - Metastasis in more than 1 regional lymph node