Tumours of the kidney

Benign tumours are usually incidental findings seldom causing symptoms.

Renal Cell Carcinoma
This is the commonest kidney tumour in adults, rarely presenting before the age of 40 years. The tumour may be solitary, multiple or at times bilateral.

Clinical features
Patients present with haematuia (blood in urine), abdominal mass and pain in the flank(s). Some may present with hypertension.

Rarely, a left sided varicocele may be associated with renal cell caner affecting the left kidney.

Diagnosis
Intravenous urography (IVU) may show space occupying lesion with distortion of the collecting system.

Ultrasound scan
Computer Tomography and MRI increase ability to stage the disease.

Treatment
Total nephrectomy unless bilateral tumour exist or the expectant remaining kidney has a poor function then partial nephrectomy may be done.

Chemotherapy and immunotherapy may be used with medroxyprogesterone or IL-2 respectively.

Prognosis
Depends on the stage of the disease and presence of metastasis being better in those the disease is limited to the kidney.