Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- asymptomatic (incidental finding)
- hematuria
- flank pain
- palpable abdominal mass
Outros fatores diagnósticos
- nonspecific systemic symptoms
- signs of hepatic dysfunction
- myoneuropathy
- lower limb edema
- scrotal varicocele
- dermatologic manifestation (hereditary syndromes)
- vision loss (von Hippel-Lindau)
Fatores de risco
- smoking
- male sex
- age over 55 years
- residence in developed countries
- non-Hispanic American Indian/Alaska Native ethnicity
- obesity
- hypertension
- positive family history of RCC
- history of hereditary syndromes
- history of acquired renal cystic disease
- asbestos/cadmium exposure
- obstetric history/estrogen exposure
- pelvic radiation
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- CT abdomen/pelvis
- CT chest
- MRI abdomen/pelvis
- abdominal/pelvic ultrasound
- CBC
- LDH
- corrected calcium
- liver function tests
- coagulation profile
- creatinine
- estimated GFR
- urinalysis
Investigações a serem consideradas
- MRI brain/spine
- bone scan
- biopsy
- surgical pathology
- genetic evaluation
Novos exames
- PET scan
Algoritmo de tratamento
small renal mass or RCC stage 1 or 2
RCC stage 3
RCC stage 4 (metastatic disease)
Colaboradores
Autores
Rodrigo R. Pessoa, MD, PhD
Urology Fellow
Department of Urology
Mayo Clinic
Rochester
MN
Declarações
RRP declares that he has no competing interests.
Simon Kim, MD, MPH
Associate Professor of Surgery
Associate Program Director
Anschutz Medical Campus
University of Colorado
UCSOM Division of Urology
Denver
CO
Declarações
SK declares that he has no competing interests.
Agradecimentos
Dr Rodrigo R. Pessoa and Dr Simon Kim would like to gratefully acknowledge Dr Amishi Y. Shah, Dr Sonal Gandhi, and Jennifer J. Knox, previous contributors to this topic.
Declarações
AYS has an unpaid advisory role for Merck pharmaceuticals. SG and JJK declare that they have no competing interests.
Revisores
Stephen A. Boorjian, MD
Assistant Professor
Fox Chase Cancer Center
Philadelphia
PA
Declarações
SAB has been reimbursed by Pfizer for serving on its speakers bureau. SAB is co-author of a reference cited in this topic.
Thomas J. Guzzo, MD, MPH
Assistant Professor of Urology and Surgery
The Hospital of the University of Pennsylvania
Philadelphia
PA
Declarações
TJG declares that he has no competing interests.
Jonathan Waxman, BSc, MBBS, MD, FRCP
Professor of Oncology
Imperial College
London
UK
Declarações
JW declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
American Urological Association. Renal mass and localized renal cancer: evaluation, management, and follow up. 2021 [internet publication].Texto completo
Escudier B, Porta C, Schmidinger M, et al. Renal cell carcinoma: ESMO clinical practice guidelines for diagnosis, treatment, and follow-up. Ann Oncol. 2019 May;30(5):706-20.Texto completo Resumo
European Association of Urology. Renal cell carcinoma. 2023 [internet publication].Texto completo
National Cancer Comprehensive Network. NCCN clinical practice guidelines in oncology: kidney cancer [internet publication].Texto completo
American College of Radiology. ACR appropriateness criteria: post-treatment follow-up and active surveillance of clinically localized renal cell carcinoma. 2021 [internet publication].Texto completo
Rathmell WK, Rumble RB, Van Veldhuizen PJ, et al. Management of metastatic clear cell renal cell carcinoma: ASCO guideline. J Clin Oncol. 2022 Sep 1;40(25):2957-95.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Benign renal cyst
- Ureteric cancer
- Bladder cancer
Mais Diagnósticos diferenciaisDiretrizes
- NCCN clinical practice guidelines in oncology: kidney cancer
- Management of metastatic clear cell renal cell carcinoma
Mais DiretrizesFolhetos informativos para os pacientes
Kidney cancer
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