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RENAL CELL ADENOCARCINOMA

  • The commonest histology is clear cell adenocarcinoma of the kidney
  • other histologic type of importance is the transitional cell cancer of the renal pelvis
  • childhood tumors of the kidneys include : Wilm's tumor and Nephroblastoma
  • there is no clear important etiologic factors
  • it has been associated with smoking, estrogen exposure, heavy metals and viral infections
  • commoner in males
  • familial cancer of the kidney is associated with von Hippel-Landau disease which is associated with bilateral renal cancer
  • some tumors have spontaneously regressed


SIGNS AND SYMPTOMS

  • flank pain, flank mass and hematuria
  • weight loss, fever, hypertension
  • anemia
  • paraneoplastic syndromes e.g. erythrocytosis, hypercalcemia, cachexia
  • Stauffer's syndrome: renal hepatopathy. Resolves once the tumor is resected
  • Polyneuropathy
  • Amyloidosis


TREATMENT

  • surgery is the mainstay of treatment for localized disease and it offers the chance for cure
  • other systemic therapies have not proven to be of much benefit : Interleukin 2 and LAK cells
  • in metastatic disease, surgery may be required to prevent hemorrhage and control pain
  • hypercalcemia, anemia, cachexia,
  • chemotherapy is of no benefit.
  • Thalidomide is being tried as an inhibitor of angiogenesis.