| 词条 | Kidney tumour | |||||||||||||||||||||||||||
| 释义 |
| name = Kidney tumour | image = Renal oncocytoma2.jpg | caption = Micrograph of a renal oncocytoma, a type of benign kidney tumour. H&E stain. | pronounce = | synonyms = Kidney tumors, renal tumours | field = Oncology, nephrology | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} Kidney tumours are tumours, or growths, on or in the kidney. These growths can be benign or malignant (kidney cancer). PresentationKidney tumours may be discovered on medical imaging incidentally (i.e. an incidentaloma), or may be present in patients as an abdominal mass or kidney cyst, hematuria, abdominal pain, or manifest first in a paraneoplastic syndrome that seems unrelated to the kidney.[1] DiagnosisA CT scan is the first choice modality for workup of solid masses in the kidneys. Nevertheless, hemorrhagic cysts can resemble renal cell carcinomas on CT, but they are easily distinguished with Doppler ultrasonography (Doppler US). In renal cell carcinomas, Doppler US often shows vessels with high velocities caused by neovascularization and arteriovenous shunting. Some renal cell carcinomas are hypovascular and not distinguishable with Doppler US. Therefore, renal tumors without a Doppler signal, which are not obvious simple cysts on US and CT, should be further investigated with contrast-enhanced ultrasound, as this is more sensitive than both Doppler US and CT for the detection of hypovascular tumors.[2] Renal ultrasonographyOn renal ultrasonography, a solid renal mass appears in the US exam with internal echoes, without the well-defined, smooth walls seen in cysts, often with Doppler signal, and is frequently malignant or has a high malignant potential. The most common malignant renal parenchymal tumor is renal cell carcinoma (RCC), which accounts for 86% of the malignancies in the kidney. RCCs are typically isoechoic and peripherally located in the parenchyma, but can be both hypo- and hyper-echoic and are found centrally in medulla or sinus. The lesions can be multifocal and have cystic elements due to necrosis, calcifications and be multifocal (Figure 8 and Figure 9). RCC is associated with von Hippel–Lindau disease, and with tuberous sclerosis, and US has been recommended as a tool for assessment and follow-up of renal masses in these patients.[2] ClassificationThere are many forms of kidney tumours: Malignant (cancerous)
Benign
Surgical complexityThe RENAL Nephrometry Scoring System is used to measure the complexity of kidney tumors for surgical excision, and is estimated by CT scan as follows:[4]
A higher score indicates a higher difficulty in removing the tumor surgically, potentially making nephrectomy necessary. References1. ^{{cite journal | vauthors = Gill IS, Aron M, Gervais DA, Jewett MA | title = Clinical practice. Small renal mass | journal = N. Engl. J. Med. | volume = 362 | issue = 7 | pages = 624–34 | date = February 2010 | pmid = 20164486 | doi = 10.1056/NEJMcp0910041 }} 2. ^1 2 3 Content initially copied from: {{cite journal | vauthors = Hansen KL, Nielsen MB, Ewertsen C | title = Ultrasonography of the Kidney: A Pictorial Review | journal = Diagnostics (Basel) | volume = 6 | issue = 1 | pages = | date = December 2015 | pmid = 26838799 | pmc = 4808817 | doi = 10.3390/diagnostics6010002 }} [https://creativecommons.org/licenses/by/4.0/ (CC-BY 4.0)] 3. ^{{cite journal | vauthors = Gooskens SL, Houwing ME, Vujanic GM, Dome JS, Diertens T, Coulomb-l'Herminé A, Godzinski J, Pritchard-Jones K, Graf N, van den Heuvel-Eibrink MM | title = Congenital mesoblastic nephroma 50 years after its recognition: A narrative review | journal = Pediatric Blood & Cancer | volume = 64 | issue = 7 | pages = | year = 2017 | pmid = 28124468 | doi = 10.1002/pbc.26437 | url = }} 4. ^{{cite journal | vauthors = Parsons RB, Canter D, Kutikov A, Uzzo RG | title = RENAL nephrometry scoring system: the radiologist's perspective | journal = American Journal of Roentgenology | volume = 199 | issue = 3 | pages = W355–9 | date = September 2012 | pmid = 22915426 | doi = 10.2214/AJR.11.8355 }} External links{{Medical resources| DiseasesDB = | ICD10 = | ICD9 = | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = }}{{Urologic neoplasia}} 1 : Kidney cancer |
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