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Renal Cell Carcinoma

Kriti Mittal, MS, MD and Jennifer Yates, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Renal cell carcinoma (RCC) arises from the parenchyma of the kidney (as opposed to urothelial cancer, which arises from the renal pelvis/calyces). According to SEER, there is estimat...

DIAGNOSIS

HISTORY

  • >60% of RCCs are incidental findings in asymptomatic patients due to increased use of ultrasound, CT scan, and MRI.

  • Hematuria: 50–60%

  • Flank pain: 35–40%

  • Weight loss: 28–36%

  • Pyrexia: 7–...

TREATMENT

  • Active surveillance is an accepted modality for SRMs. Most protocols include patients with renal masses ≤4 cm. The mean growth rate of SRMs (small renal masses) on AS protocol demonstrates m...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • The majority of recurrences will occur in the first 3 years after treatment.

  • Radiographic follow-up is based on risk as established in the AUA gu...

REFERENCES

1
Motzer  RJ, Tannir  NM, McDermott  DF, et al; for CheckMate 214 Investigators. Nivolumab plus ipilimumab versus sunitinib in advanced renal-cell carcinoma. N Engl J...

CODES

ICD10

  • C64.9 Malignant neoplasm of unsp kidney, except renal pelvis

  • C64.1 Malignant neoplasm of right kidney, except renal pelvis

  • C64.2 Malignant neoplasm of left kidney, except renal pelvis

  • C64 Mali...

CLINICAL PEARLS

  • RCC is the eight most common cancer in the United States, with the majority of cases detected incidentally.

  • At presentation, up to 1/3 of patients with RCC have metastatic disease.

  • Surge...

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