It's the commonest malignant tumour of the kidney, also known as hypernephroma.
The peak incidence is around the age of 50-70s, male predominance.
The tumour arises from the renal tubules.
Early spread is common in Renal adenocarcinoma :
a) Direct - involving the perinephric tissue, extension into the renal veins, and then the IVC
b) Lymphatic - involving the ipsilateral para-aortic lymph nodes
c) Hematogenous - pelvic bone, vertebras, lungs, etc
1) History suggestive of RCC
Painless hematuria (usually a total hematuria)
General debility (lost of weight, appetite, malaise, weakness)
Bony pain and pathological fractures
Fixed loin pain (pressure over the renal capsule)
Occasionally, a loin mass is felt by the patient
Less common presentations :
a) Pyrexia of unknown origin
b) Varicocele/Bilateral pedal edema
Extension of the tumour involving the left gonadal veins or into the IVC
Excessive production of erythropoeitin from the malignant cells
Facial, skin over palm/soles redness, recurrent venous/arterial thromboses
d) Sudden severe abdominal pain
Haemorrhage into the tumour
e) Hypertension - rare complication
2) On examination
Evidence of recent weight lost
Palpable loin mass, kidney (ballotable), may be tender
Evidence of lung metastases
CT abdomen, mainly for staging
RCC is a radio and chemoresistant tumour, hence the only option is radical nephrectomy, including the perinephric tissue and ipsilateral para-aortic lymph nodes.