malignant renal masses

renal cell carcinoma (RCC)/hypernephroma/adenocarcinoma of the kidney

primary form of renal cancer → begins in the kidney specifically from the renal tubular epithelium

RCC has a strong association with what disease?

von Hippel-Lindau disease

risk factors for RCC include:

• smoking

• HTN

• obesity

• tuberous sclerosis

• acquired renal cystic disease

clinical findings of renal cell carcinoma:

• anorexia

• flank pain

• gross hematuria

• palpable mass

• smoker

• weight loss

sonographic findings of renal cell carcinoma:

• hypoechoic, isoechoic, or hyperechoic solid mass on the kidney

• can have a complex cystic appearance as well

• check renal vein and IVC for tumor invasion

• check for distant metastasis, including contralateral kidney and liver

renal transitional cell carcinoma (TCC)

a malignant tumor that is most often found in the area of the renal pelvis

clinical findings of renal TCC:

• gross hematuria

• pain secondary to renal obstruction

• hx of smoking

sonographic findings of renal TCC:

• hypoechoic or isoechoic mass within the renal sinus

• varying degrees of hydronephrosis may be present

metastases to the kidneys are most often from:

lungs or breast

less common metastases to the kidneys are from:

• prostate

• pancreas

• melanoma

• contralateral kidney → RCC metastasis

clinical findings of other renal malignancies:

• hx of primary cancer → often lung or breast

• hematuria

• fever

• weight loss

sonographic findings of other renal malignancies:

• bilateral, hypoechoic masses with lymphoma

• lymphoma or leukemia can manifest as an enlarged kidney

• metastases have varying sonographic findings but are most often solid tumors that are hypoechoic or hyperechoic

• lymphoma (most likely non-Hodgkin), will typically affect both kidneys