Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- asymptomatic (incidental finding)
- haematuria
- flank pain
- palpable abdominal mass
Other diagnostic factors
- non-specific systemic symptoms
- signs of hepatic dysfunction
- myoneuropathy
- lower limb oedema
- scrotal varicocele
- dermatological manifestation (hereditary syndromes)
- vision loss (von Hippel Lindau)
Risk factors
- smoking
- male sex
- age over 55 years
- residence in developed countries
- black/American-Indian ethnicity
- obesity
- hypertension
- positive family history of RCC
- history of hereditary syndromes
- history of acquired renal cystic disease
- asbestos/cadmium
- obstetric history/oestrogen exposure
- pelvic radiation
Diagnostic investigations
1st investigations to order
- FBC
- LDH
- corrected calcium
- liver function tests
- coagulation profile
- creatinine
- urinalysis
- abdominal/pelvic ultrasound
- CT abdomen/pelvis
- MRI abdomen/pelvis
Investigations to consider
- CT chest
- MRI brain/spine
- bone scan
- biopsy
- surgical pathology
Treatment algorithm
Contributors
Authors
Urology physician
Anshutz Medical Campus
University of Colorado
UCASOM Division of Urology
Denver
CO
Disclosures
RRP declares that he has no competing interests.
Associate Professor of Surgery
Associate Program Director
Anschutz Medical Campus
University of Colorado
UCSOM Division of Urology
Denver
CO
Disclosures
SK declares that he has no competing interests.
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.
Disclosures
AYS has an unpaid advisory role for Merck pharmaceuticals. SG and JJK declare that they have no competing interests.
Peer reviewers
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 this topic.
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.
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