Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • asymptomatic (incidental finding)
  • flank pain
  • palpable abdominal mass
  • hematuria

Other diagnostic factors

  • nonspecific systemic symptoms
  • signs of hepatic dysfunction
  • myoneuropathy
  • lower limb edema
  • scrotal varicocele
  • dermatologic manifestation (hereditary syndromes)
  • dental pits (tuberous sclerosis)
  • nail manifestations (tuberous sclerosis)
  • vision loss (von Hippel Lindau)

Risk factors

  • smoking
  • male gender
  • age 55 to 84 years
  • residence in developed countries
  • black/American-Indian ethnicity
  • obesity
  • hypertension
  • positive family history (FHx) of RCC
  • history of hereditary syndromes
  • history of acquired renal cystic disease
  • asbestos/cadmium/petroleum exposure
  • obstetric history/estrogen exposure
  • pelvic radiation

Diagnostic investigations

1st investigations to order

  • CBC
  • LDH
  • corrected calcium
  • liver function tests (LFTs)
  • coagulation profile
  • creatinine
  • urinalysis
  • abdominal/pelvic ultrasound
  • CT abdomen/pelvis
  • MRI abdomen/pelvis
Full details

Investigations to consider

  • CT chest
  • MRI brain/spine
  • bone scan
  • biopsy
  • surgical pathology
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Assistant Professor

Genitourinary Medical Oncology

MD Anderson Cancer Center

Houston

TX

Disclosures

AYS has an unpaid advisory role for Merck pharmaceuticals.

Dr Amishi Y. Shah would like to gratefully acknowledge Dr Sonal Gandhi and Jennifer J. Knox, previous contributors to this topic. SG and JJK declare that they have no competing interests.

Peer reviewers VIEW ALL

Assistant Professor

Fox Chase Cancer Center

Philadelphia

PA

Disclosures

SAB has been reimbursed by Pfizer for serving on its speakers bureau. SAB is co-author of a reference cited in the monograph.

Assistant Professor of Urology and Surgery

The Hospital of the University of Pennsylvania

Philadelphia

PA

Disclosures

TJG declares that he has no competing interests.

Professor of Oncology

Imperial College

London

UK

Disclosures

JW declares that he has no competing interests.

Use of this content is subject to our disclaimer