Урология - Tumors
.pdfTumors
Renal tumors
Aethiology
There is no single reason
Smoking increases risk of having a kidney tumor
Occupation – coke oven workers, asbestos
Radiation exposure, therapy, thorotrast
Phenacetin
Von Hippel-Linday disease
Classification
Tumors of renal parencyma
Benigh: adenoma, lypoma, fibrioma, angioma and haemangioma, mixoma, dermoid
Malignant: nephrocellular cancer, fibro-, myo-, lypo-, angio-sarcoma, Wilm’s tumor
Secondary ( matestatic) tumor of kidney
Classification
Tumors of renal pelvis
Benigh: papilloma, angioma, leyoma
Malignant: transitional cell carcinoma, adenomucose carcinoma, squamose cell carcinoma, sarcoma.
Symptoms and clinic
General symptoms: loss of weight, worthening of general condition, elevation of ESR, erytrocytosis, arterial hypertension.
Local: haematuria at (30-70 %) of patients, palpable tumor, pain in lumbal area, varicocele.
Asymptomatic
Symtoms of metastatic affection of other organs
Lungs: picture of pnemonia or tuberculosis (miliar metastasis), or like bronchogenic cancer (solitary tumor)
Bones: intencieve pain, non stopping even after intake of narcotic analgetics, patologic fructures. Sometimes looks like radiculitis or neuralgia.
Diagnostics
Ultrasound
CT
Magnetic resonance tomography
Radioisotope nephroscintygraphy
Renal angiography (rarely)
Punction biopsy
TNM classification
Primary tumor (T)
TX - Primary tumor cannot be assessed
T0 - No evidence of primary tumor
T1 - Tumor 7 cm or smaller in greatest dimension, limited to the kidney
T2 - Tumor larger than 7 cm in greatest dimension, limited to the kidney
T3 - Tumor extends into major veins or invades adrenal gland or perinephric tissues but not beyond the Gerota fascia
T3a - Tumor invades adrenal gland or perinephric tissues but not beyond the Gerota fascia
T3b - Tumor grossly extends into the renal vein(s) or vena cava below the diaphragm
T3c - Tumor grossly extends into the renal vein(s) or vena cava above the diaphragm
T4 - Tumor invading beyond the Gerota fascia
TNM
Regional lymph nodes (N) - Laterality does not affect the N classification
NX - Regional lymph nodes cannot be assessed
N0 - No regional lymph node metastasis
N1 - Metastasis in a single regional lymph node
N2 - Metastasis in more than 1 regional lymph node