Resumo
Definição
History and exam
Key diagnostic factors
- asymptomatic (incidental finding)
- hematuria
- flank pain
- palpable abdominal mass
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)
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
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
Investigations to consider
- MRI brain/spine
- bone scan
- biopsy
- surgical pathology
- genetic evaluation
Emerging tests
- PET scan
Treatment algorithm
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
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.
Diferenciales
- Benign renal cyst
- Ureteric cancer
- Bladder cancer
Más DiferencialesGuías de práctica clínica
- NCCN clinical practice guidelines in oncology: kidney cancer
- Management of metastatic clear cell renal cell carcinoma
Más Guías de práctica clínicaFolletos para el paciente
Kidney cancer
Más Folletos para el pacienteInicie sesión o suscríbase para acceder a todo el BMJ Best Practice
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