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Renal cell carcinoma
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Renal cell carcinoma

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Contributors: Christine Osborne MD, Catherine Moore MD
Other Resources UpToDate PubMed


Renal cell carcinoma accounts for 90%-95% of malignant neoplasms arising from the kidney. Peak incidence is between ages of 50-70 years with a male-to-female ratio of 2:1. Risk factors for development of renal cell carcinoma include cigarette smoking, acquired cystic disease of the kidney associated with end-stage renal disease (ESRD), tuberous sclerosis, and the autosomal-dominant, often familial, von Hippel-Lindau syndrome.

Clinical presentation includes hematuria, abdominal pain, flank mass or abdominal mass, fever, weight loss, anemia, or varicocele. Many patients have tumors discovered incidentally with abdominal imaging performed for another reason.

The most common category of renal cell carcinoma is clear cell carcinoma, accounting for 60% of cases, and this histologic form is found in >80% patients with metastases. Other categories include bilateral and multifocal papillary tumors (5%-15%), indolent chromophobe tumors (5%-10%), benign oncocytomas (5%-10%), and rare but aggressive Bellini duct tumors (<1%).

Microphthalmia-associated transcription factor (MiT) family translocation renal cell carcinoma is a rare form that occurs in young patients who do not have associated risk factors.


C64.9 – Malignant neoplasm of unspecified kidney, except renal pelvis

702391001 – Renal cell carcinoma

Differential Diagnosis & Pitfalls

Renal mass:
  • Complex renal cyst
  • Renal angiomyolipoma
  • Oncocytoma
  • Metanephric adenoma
  • Xanthogranulomatous pyelonephritis, a rare form of pyelonephritis involving chronic inflammation
  • Metastatic disease

Best Tests

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Last Updated: 11/30/2018
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Renal cell carcinoma
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Renal cell carcinoma : Flank pain, Abdominal mass, Microscopic hematuria, Weight loss, Ca elevated
Imaging Studies image of Renal cell carcinoma
Unenhanced axial CT scan of the abdomen and pelvis with solid mass at the lower pole in right kidney, consistent with renal cell carcinoma.
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