Ultrasound manifestation of renal cancer

Written by Shen Jiang Chao
Radiology
Updated on October 25, 2024
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Kidney cancer is the most common type of kidney malignancy. Pathologically, it is mainly divided into clear cell renal cell carcinoma, chromophobe renal cell carcinoma, papillary renal carcinoma, and collecting duct carcinoma, with clear cell renal cell carcinoma being the most common. Ultrasonographically, it usually appears as round or oval masses, varying in size but generally around 2-4 cm, exhibiting low to medium echo patterns. If the tumor is larger, greater than 5 cm, it may show changes in mixed echo patterns due to possible internal bleeding or cystic changes when the tumor is large. When kidney cancer is suspected on ultrasound, it is best to further proceed with enhanced MRI or enhanced CT scanning.

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Written by Xu Chun Hua
Urology
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How is kidney cancer diagnosed?

Hematuria, pain, and lumps are the main symptoms of kidney cancer. If one or two of these symptoms appear, the possibility of kidney cancer should be considered. About half of the patients are found to have incidental kidney cancers, also known as asymptomatic kidney cancers, during physical examinations through incidental findings on ultrasound or CT scans. Some may show early symptoms of metastasis making the diagnosis quite challenging. The preoperative diagnosis of kidney cancer relies on the results of medical imaging examinations such as ultrasound, X-rays, and CT scans. CT scans have a very high confirmation rate for kidney cancer and are currently the most reliable imaging method for diagnosing kidney cancer.

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Written by Yan Chun
Oncology
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Kidney cancer most commonly metastasizes to which locations?

Kidney cancer clinically tends to metastasize through direct spread, the lymphatic pathway, and the hematogenous pathway. The lymphatic route often involves enlargement of the perirenal lymph nodes or the lymph nodes in the groin or retroperitoneum. Kidney cancer is also prone to metastasize to the lungs, liver, bones, and other parts via the bloodstream. Similarly, kidney cancer can spread to the perirenal area, ureters, bladder, and other parts through direct extension. Once kidney cancer metastasizes to other organs, it is considered to be in the advanced stages clinically, and treatment primarily involves targeted therapy, chemotherapy, and other comprehensive treatment measures, with surgical treatment not being used as the primary anti-tumor treatment. Once kidney cancer has metastasized, the clinical staging is late, and the prognosis for the patients is poor.

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Written by Zhou Qi
Nephrology
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Is kidney cancer the same as uremia?

Kidney cancer and uremia are two completely different concepts. Kidney cancer refers to the presence of a malignant tumor, which is a malignant lesion in kidney-type tissues. Certain cells in the kidney are in a state of limitless proliferation, continuously replicating to form kidney-like masses, and may cause hematuria, or even squeeze kidney tissues affecting their function. Uremia, on the other hand, refers to long-term chronic damage to the kidneys from various diseases, leading to the destruction of over 90% of kidney tissue, rendering the kidneys unable to excrete metabolic waste. This results in azotemia, electrolyte disorders, and other complications, a state known as uremia. Patients with kidney cancer, if the damage to kidney tissues is not severe, may still have normal kidney function. However, if severe problems occur in both kidneys, kidney cancer could also lead to uremia, although this situation is relatively rare.

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How long can someone with kidney cancer and hematuria survive?

A common symptom of kidney cancer is painless visible blood in urine, which is also the primary initial symptom. It is intermittent and sometimes accompanied by blood clots. However, after exhibiting this symptom, how long a patient can live depends on individual constitution and the severity of the condition. Once discovered, early surgical treatment is recommended, followed by immunotherapy, such as using interferons and interleukins.

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What are the early symptoms of kidney cancer?

Many cases of kidney cancer often have no obvious symptoms in their early stages and are not discovered until the tumor progresses. After the tumor progresses, symptoms may include hematuria, which can be intermittent, painless, and visible throughout its course. There may also be back pain and a lump in the abdomen, which is evident in about twenty percent of cases. Slim individuals might find it easier to detect such lumps. There are also some extrarenal manifestations including fever, weight loss, accelerated erythrocyte sedimentation rate, anemia, hypertension, polycythemia, hypercalcemia, liver function impairment, etc. These symptoms might appear in the early stages. However, symptoms can vary from person to person.