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Renal cell carcinoma

Última revisão: 20 Aug 2025
Última atualização: 12 Dec 2024

Resumo

Definição

History and exam

Key diagnostic factors

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

Other diagnostic factors

  • nonspecific systemic symptoms
  • signs of hepatic dysfunction
  • myoneuropathy
  • lower limb edema
  • scrotal varicocele
  • dermatologic manifestation (hereditary syndromes)
  • vision loss (von Hippel-Lindau)
Full details

Risk factors

  • 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
Full details

Diagnostic investigations

1st investigations to order

  • CT abdomen/pelvis
  • CT chest
  • MRI abdomen/pelvis
  • abdominal/pelvic ultrasound
  • CBC
  • LDH
  • corrected calcium
  • liver function tests
  • coagulation profile
  • creatinine
  • estimated GFR
  • urinalysis
Full details

Investigations to consider

  • MRI brain/spine
  • bone scan
  • biopsy
  • surgical pathology
  • genetic evaluation
Full details

Emerging tests

  • PET scan

Treatment algorithm

ONGOING

small renal mass or RCC stage 1 or 2

RCC stage 3

RCC stage 4 (metastatic disease)

Contributors

Authors

Rodrigo R. Pessoa, MD, PhD

Urology Fellow

Department of Urology

Mayo Clinic

Rochester

MN

Disclosures

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

Divulgaciones

SK declares that he has no competing interests.

Agradecimientos

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.

Divulgaciones

AYS has an unpaid advisory role for Merck pharmaceuticals. SG and JJK declare that they have no competing interests.

Revisores por pares

Stephen A. Boorjian, MD

Assistant Professor

Fox Chase Cancer Center

Philadelphia

PA

Divulgaciones

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

Divulgaciones

TJG declares that he has no competing interests.

Jonathan Waxman, BSc, MBBS, MD, FRCP

Professor of Oncology

Imperial College

London

UK

Divulgaciones

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.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

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  Resumen

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  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
  • Renal cell carcinoma images
  • Diferenciales

    • Benign renal cyst
    • Ureteric cancer
    • Bladder cancer
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  • Guías de práctica clínica

    • NCCN clinical practice guidelines in oncology: kidney cancer
    • Management of metastatic clear cell renal cell carcinoma
    Más Guías de práctica clínica
  • Folletos para el paciente

    Kidney cancer

    Más Folletos para el paciente
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