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7 - Imaging characteristics of unusual renal cancers

Published online by Cambridge University Press:  08 August 2009

By
Anju Sahdev  and
Rodney H. Reznek
Edited by
Uday Patel
Anju Sahdev
Affiliation:
Consultant, Radiologist, Department of Diagnostic Imaging, St. Bartholomew's Hospital, West Smithfield, London, UK
Rodney H. Reznek
Affiliation:
Professor of Diagnostic Imaging, Cancer Imaging, Institute of Cancer, St Bartholomew's Hospital, West Smithfield, London, UK
Uday Patel
Affiliation:
St George's Hospital, London
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Summary

Introduction

A wide variety of malignant neoplasms have been described in the kidney, but 90% of primary renal cancers are classified as renal cell carcinomas (RCC). Transitional cell carcinomas (TCC) account for about 5%–8% of renal cancers; and nephroblastomas, sarcomas, lymphoma, and metastases commonly from breast, bronchus, and malignant melanoma account for a further 5% of renal cancers.

The increased use of ever-evolving cross-sectional imaging has resulted in early and incidental diagnosis of renal cancers. Up to 40% of renal tumors are now incidentally detected and at an earlier stage. For example, 82% of incidentally detected tumors are below stage pT3 compared with only 35% of symptomatic tumors and the disease-free and 5-year survival time is significantly better in lower stage tumors. These favorable prognostic features allow recent developments in localized lesion therapies such as ablation techniques, embolization and nephron-sparing surgery to be offered as practical treatment options to conventional nephrectomy. However, histological subtypes with a poor prognosis such as collecting duct carcinomas, sarcomas and TCCs are not suitable for these nephron-sparing treatment options. Lymphoma and metastatic lesions require systemic chemotherapy. Furthermore, although localized treatment may be offered to patients with locally advanced renal cancer and intractable hematuria in a palliative setting, recent developments in targeted chemotherapy may alter the approach to these patients (as discussed in Chapter 1). It is also important to know the histological subtype of the renal cancer prior to embarking on localized treatment options.

Type
Chapter
Information
Carcinoma of the Kidney , pp. 126 - 154
Publisher: Cambridge University Press
Print publication year: 2007

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  • Imaging characteristics of unusual renal cancers
    • By Anju Sahdev, Consultant, Radiologist, Department of Diagnostic Imaging, St. Bartholomew's Hospital, West Smithfield, London, UK, Rodney H. Reznek, Professor of Diagnostic Imaging, Cancer Imaging, Institute of Cancer, St Bartholomew's Hospital, West Smithfield, London, UK
  • Edited by Uday Patel, St George's Hospital, London
  • Book: Carcinoma of the Kidney
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545436.009
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  • Imaging characteristics of unusual renal cancers
    • By Anju Sahdev, Consultant, Radiologist, Department of Diagnostic Imaging, St. Bartholomew's Hospital, West Smithfield, London, UK, Rodney H. Reznek, Professor of Diagnostic Imaging, Cancer Imaging, Institute of Cancer, St Bartholomew's Hospital, West Smithfield, London, UK
  • Edited by Uday Patel, St George's Hospital, London
  • Book: Carcinoma of the Kidney
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545436.009
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  • Imaging characteristics of unusual renal cancers
    • By Anju Sahdev, Consultant, Radiologist, Department of Diagnostic Imaging, St. Bartholomew's Hospital, West Smithfield, London, UK, Rodney H. Reznek, Professor of Diagnostic Imaging, Cancer Imaging, Institute of Cancer, St Bartholomew's Hospital, West Smithfield, London, UK
  • Edited by Uday Patel, St George's Hospital, London
  • Book: Carcinoma of the Kidney
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545436.009
Available formats
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