Renal Cancer

Exam Cram 

• Renal Cancer is predominantly renal cell carcinoma (90%), the vast majority are sporadic

• Presentation: haematuria, loin pain

• Investigations: raised Hb, CXR- cannonball metastasis

• Diagnosis: biopsy

Outline 

Assessment

History

• Weight loss, anorexia, reduced exercise tolerance

• Mass, haematuria

Examination

• Ballotable flank

• Left testicular varicocele 

• Haemoglobin- upper limit of normal

• Mass in childhood- Wilms's tumour

Investigations

• Urine analysis: blood

• CTKUB/ CT Renal triple phase: mass

• CXR: cannon ball metastasis

• Polycythaemia (raised Hb) from increased EPO

Diagnosis

Diagnostic criteria: histology of biopsy

Differentials: Bladder Cancer 

Classification: TMN staging + histological grade

Management

1. Confirm diagnosis on biopsy & assess stage 

2. Nephrectomy if limited to kidney

Med Reg Notes

Wilms Tumour is a type of kidney cancer presenting in childhood with a palpable mass

Management: 

Surgery first line

• If < 7mm consider partial nephrectomy

• If > 7mm nephrectomy

Resources and References

1. Pandey J, Syed W. Renal Cancer. [Updated 2024 Oct 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558975/

Written in 2025