Renal Cancer

Renal cancer, also known as renal cell carcinoma (RCC), is a malignant tumor originating from the renal tubular epithelium, characterized by local invasion, vascular involvement, and potential metastasis to lungs, bones, and liver.

Definition

Renal cancer, also known as renal cell carcinoma (RCC), is a malignant tumor originating from the renal tubular epithelium, characterized by local invasion, vascular involvement, and potential metastasis to lungs, bones, and liver.

Epidemiology

Accounts for 2–3% of adult malignancies
Median age at diagnosis: 60–65 years
Male-to-female ratio approximately 2:1
Incidence higher in developed countries
Risk factors include smoking, obesity, hypertension, chronic kidney disease, and genetic syndromes (Von Hippel-Lindau)

Etiology

Genetic mutations: VHL gene in clear cell RCC, MET, FLCN, FH mutations in hereditary syndromes
Environmental factors: smoking, obesity, occupational exposures
Chronic kidney disease and acquired cystic kidney disease
Family history of RCC
Hypertension and long-term dialysis

Pathophysiology

Malignant transformation of renal tubular epithelial cells
Tumor growth within the renal parenchyma with potential invasion into renal vein and IVC
Angiogenesis promoted by VHL/HIF pathway dysregulation
Hematogenous spread to lungs, bones, liver, and brain
Paraneoplastic syndromes: polycythemia, hypercalcemia, hypertension
Local invasion may compress adjacent structures leading to hematuria and flank pain