Everything you need to know about chromophobe kidney carcinoma

Chromophobe cancer of the right or left kidney is a serious disease that is a malignant change in tissue. An uncontrolled process of cell reproduction begins in them.

The tissues grow and the normal functioning of the organ is disrupted.

With this disease, other organs also suffer due to the spread of metastases.

The prognosis for kidney cancer is disappointing, and treatment is effective only in the early stages.

Characteristics of kidney tumors

The main difference between cancer cells is their abnormally rapid growth. Forming in the tissues of the kidney parenchyma, they multiply quickly. A malignant neoplasm develops.

The tumor is usually surrounded by a capsule. It occurs in one, and in some cases in both kidneys.

Nephroblastomas most often occur in young children no older than 5 years.

In addition to this fairly common type of tumor, there are also rarer types of kidney cancer:

• protococcal;
• papillary;
• chromophobic;
• oncocytic.

Bellini collecting duct carcinoma is often diagnosed at an advanced stage. There is also sarcoma that affects connective tissue. It spreads throughout the body, developing in the lymph nodes, bones and other organs.

Regardless of the type, all tumors go through the following stages of development:

1. First. During this period, the tumor grows slowly. Abnormal cells are localized in the kidney tissues, the neoplasm does not extend beyond them.
2. Second stage. The size of the neoplasm reaches 7 cm or more.
3. The third stage is characterized by the involvement of blood vessels and lymph nodes in pathological processes.
4. Fourth stage. The formation of metastases is observed in the lungs, liver and bones.

At the last stage, a person’s temperature rises significantly, as active decay of the tumor occurs. The patient experiences excruciating pain that is difficult to relieve.

Types of kidney cancer

Kidney cancer is a malignant tumor that can metastasize to neighboring and distant organs of the human body.
Originates in the area of ​​the inner layers of the kidney tubules. It affects one or two organs of the urinary system. Any folk remedies must be agreed upon with a doctor. These methods cannot be the main method of treating a tumor. Used as additional therapy. These are all kinds of infusions, decoctions, compresses, etc.

Many infusions intended for oral administration can remove toxins from the affected organ. Herbal teas will boost your overall immunity. It is important to know the required dosage and duration of use.

• renal cell carcinoma (parenchyma cancer);
• urothelial cancer (transitional cellular, grows from cells of the pelvis);
• nephroblastoma;
• mesenchymal neoplasm;
• primary multiple cancer.

Clinical classification (TCM) of kidney cancer by size:

• indistinguishable tumor;
• the neoplasm is up to 7 cm in size, but is located within the organ;
• the tumor has grown beyond the lining of the organ.

Causes of the disease and risk group

Cancer is a disease that has received significant effort and resources to study it. It is being researched in an attempt to discover new, more effective treatments.

Despite this, the exact causes of tumor formation in the kidneys have not been identified.

A risk group has been identified, which includes elderly men and children.

It has been established that the following factors can provoke the development of cancer:

• exposure to chemicals:
• work related to the processing of petroleum products;
• radiation exposure;
• smoking;
• heredity;
• immunodeficiency.

In addition, the risk of developing a neoplasm is increased in:

• obese people;
• diabetics;
• hypertensive patients.

Squamous cell carcinoma can develop due to:

• fat metabolism disorders;
• kidney damage;
• working with solvents and dyes;
• constant contact with toxic substances;
• lack of vitamin A.

It has been found that papillary cancer can be inherited.

Wilms tumor, which most often occurs in young children, is caused by a gene mutation.

Causes of the disease

Doctors believe that the main reasons provoking the development of chromophobe cancer are genetics and heredity. The papillary type of cancer can occur under the influence of the following factors:

• alcohol abuse and smoking;
• overweight and obesity ;
• constant exposure to chemical vapors
• uncontrolled use of diuretics and analgesics.

Chromophobe kidney carcinoma often occurs as a consequence of a decrease in the body's defenses, diabetes mellitus and prolonged hemodialysis. In addition, factors such as increased blood pressure and the presence of inflammatory processes in the kidneys in the body, occurring in acute and chronic forms, can provoke the progression of the disease.

Rare types of kidney cancer

Malignant tumors most often occur in men. In women, cysts first form, and only then can cancer develop against their background.

The most common types of kidney cancer are:

Much less common:

• squamous;
• hypernephroid;
• chromophobic.

All these tumors progress rapidly and threaten the patient's life.

Renal cell

It occurs against the background of pyelonephritis, endocrine diseases, urolithiasis and various infectious diseases.

The epithelial cells of the renal tubules begin to degenerate into malignant ones.

The main symptoms of this disease include:

• severe pain radiating to the lower back, groin or thigh;
• change in urine color. Very often, urine turns pink due to the admixture of blood;
• in the later stages, when the tumor increases significantly in size, it can be determined by palpation;
• development of anemia.
• in later stages, urinary disturbances are observed.

In addition, infection may occur. In some cases, patients complain of joint pain.

After the death of the kidney, metastases spread to other organs.

This type of cancer can manifest itself in several forms:

• clear cell;
• collecting duct cancer;
• chromophobe carcinoma.

At the last stage, the chance of recovery is no more than 10%.

Squamous appearance

This tumor has the appearance of a node and develops in the kidney parenchyma. It is almost always diagnosed at the stage when metastases begin to spread. Very often, to save the patient’s life, the entire organ must be removed.

This type of disease most often occurs in women suffering from nephrolithiasis. In the peripheral form, it often grows into adipose tissue. The central form metastasizes to the lymph nodes.

Characteristic features include:

• blood in urine;
• pain localized in the side;
• compaction in the kidney tissues;
• weight loss.

As the disease progresses, the organ becomes enlarged and the lymph nodes become swollen. Metastases spread to the lungs and bones, very often both kidneys are affected.

This type of cancer is diagnosed late, and relapses often occur. The prognosis is extremely unfavorable.

How to recognize a disease in a patient?

Doctors and scientists cannot determine the main reasons that cause the transition of a healthy cell into a cancerous one. There are a number of factors that can lead to the development of kidney cancer:

• bad habits (alcohol, smoking);
• excess weight;
• poor nutrition;
• high blood pressure;
• renal failure;
• taking hormones;
• harmful working conditions;
• heredity.

Despite the fact that research is conducted every year, it is not known exactly why tumors form in the kidneys.

They most often affect older men, but some types of pathology occur in children. Causes cancer:

• contact with chemicals;
• working with petroleum products;
• radiation exposure;
• smoking;
• genetic predisposition;
• immunodeficiency.

Neoplasms occur more often in obese people, diabetics and hypertensive patients. Tumors form in the presence of polycystic disease or renal failure. It is believed that their development is facilitated by long-term use of antibiotics, analgesics, and drugs that accelerate urine excretion.

People who smoke have a significant risk of developing squamous cell cancer. The reasons for the appearance of such a tumor include:

• lipid metabolism disorder;
• kidney damage;
• working with dyes;
• constant contact with poisons and asbestos;
• lack of vitamin A.

The appearance of chromophobe cancer is also promoted by bad habits, poor diet, high blood pressure, heredity, obesity, and excess hormones.

Wilms tumor, which affects children and not older people, is formed due to gene mutation. It occurs in a few babies per million and is almost always cured.

The exact reasons for the development of kidney cancer have not yet been identified. There is only a list of factors supposedly influencing the development of pathology. Let's look at them in more detail:

1. Tobacco smoking. Heavy smokers are much more susceptible to the disease than non-smokers. Smoking cigars leads to the same consequences. In general, a bad habit of this kind can develop cancer of the lungs, stomach, bladder and other vital organs.
2. Overweight. Obesity often leads to hormonal imbalances, which provokes the development of malignant tumors.
3. Gender. Representatives of the stronger sex are twice as likely to suffer from pathology.
4. Diseases of the urinary organ that occur in severe form.
5. Hereditary predisposition. With kidney cancer, the causes often lie in poor genetics.
6. Any kind of injury. Mechanical damage to the kidneys often leads to the appearance of malignant tumors.
7. Medicines. Taking medications without a doctor's prescription uncontrollably becomes a clear factor in tumor development.

Cystic kidney cancer develops when many bubbles of fluid (cysts) form, which is a risk factor. Hypertension or medications for it can cause neoplasms of this kind.

If the tumor penetrates inside the organ after treatment, only 15% of the sick people will continue to live. If the tumor has spread to neighboring organs and there are metastases, it is not yet possible to achieve a positive result. Removing Wilms tumor at an early stage allows the child to fully recover.

To maintain your health, it is important to seek help from a doctor at the first symptoms of oncology and follow all his recommendations, and do not neglect the requirements. How long do people live with kidney cancer? With timely diagnosis and adequate treatment, a person can get rid of the pathology. In advanced cases, one cannot count on a positive outcome.

Today, a great variety of carcinogens are known, their negative effects have been proven, so the causes of most tumors are known exactly. We all know that smoking most likely leads to lung cancer, ultraviolet radiation leads to melanoma, the human papillomavirus provokes cervical cancer, but what causes kidney cancer? Scientists have not yet been able to answer this question accurately.

Despite numerous studies, it has not yet been possible to reliably determine carcinogenic factors in relation to kidney cancer; however, the role of some external causes and pathological conditions in the possibility of developing a malignant neoplasm is assumed.

Risk factors for kidney cancer include:

• Gender and age;
• Smoking;
• Obesity;
• Arterial hypertension;
• Diabetes;
• The presence of other renal pathology;
• Taking medications;
• Professional factors;

As noted above, kidney cancer is diagnosed much more often in men than in women. The reason for this difference is not entirely clear, but a higher likelihood of exposure to harmful occupational factors and the prevalence of smoking among the male population may play a role.

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Old age also greatly contributes to the risk of developing a tumor, not only due to a long time of contact with unfavorable external factors and the appearance of concomitant pathology, but also due to the accumulation of spontaneous genetic mutations, one of which can give rise to a cancer cell.

Excess weight increases the risk of kidney cancer by about 20%. The exact mechanism of its influence remains unclear, but the role of hormonal changes and the accumulation of large amounts of estrogens (female sex hormones) in adipose tissue is assumed, which has a carcinogenic effect.

Patients with arterial hypertension are 15-20% more likely to develop cancer. Perhaps it is not hypertension as such that has a negative effect, but long-term and systematic use of antihypertensive drugs.

Smoking is rightfully considered one of the most powerful carcinogens. The risk of kidney cancer in smokers is approximately one and a half times higher than in non-smokers, and quitting this addiction reduces the likelihood of developing a tumor.

Harmful working conditions that involve contact with petroleum products, dyes, as well as substances formed during the production of rubber, paper, and textiles can also cause kidney cancer.

Taking medications can cause cancer. Thus, with the systematic use of diuretics, the risk of a malignant tumor increases by about a third. Some analgesics, antibiotics, and other drugs whose metabolites are excreted in urine are also thought to increase the risk of cancer.

Among the kidney diseases that contribute to the development of cancer are end-stage chronic renal failure. This may be due to atrophy and sclerosis (overgrowth of connective tissue), leading to hypoxia and cellular damage.

The impact of diabetes continues to be debated. According to various studies, kidney cancer is more common in patients with diabetes, but since such patients in most cases also have hypertension and obesity, it is quite difficult to determine the degree of influence of each of these diseases in isolation.

It is suggested that the nature of nutrition also plays an important role in carcinogenesis. Consumption of large amounts of animal fats and fried meat increases the risk of cancer in general and kidney cancer in particular, due to the entry into the body of various types of carcinogenic substances that affect not only the mucous membrane of the gastrointestinal tract, but also, when filtered with urine, can damage renal tubular epithelium.

The role of genetic mutations in relation to renal cell cancer is being actively studied by scientists from different countries, but an exact marker for the development of neoplasia has not been established to date. Despite this, the presence of such patients among close relatives (especially sisters and brothers) is considered a risk factor for the disease.

As you can see, most of the listed potential causes of cancer are of a general nature, having a negative impact on the entire body as a whole, but they must still be taken into account as probable carcinogenic factors in relation to the risk of kidney tumors.

Scientists cannot establish the exact causes of cancer, however, there are a number of risk factors that predispose to the disease:

• Gender. Kidney cancer is more often diagnosed in male patients.
• Tobacco smoking. This bad habit doubles the risk of disease.
• Obesity. People who are prone to obesity are more likely to be diagnosed with cancer.
• Age-related changes. The risk of kidney cancer increases in patients over 50 years of age.
• Chemical effects on the body. Cadmium, asbestos and organic solvents contribute to the occurrence of cancer.
• Long-term dialysis. If the procedure is carried out over a long period of time, the patient develops cysts in the kidneys, which can be the beginning of the disease.
• Heredity. Genetic predisposition to cancer.
• Diabetes. Patients with this disease are more likely to develop cancer.

The main risk factors and causes of kidney cancer:

1. Floor. Men are more likely to get kidney cancer. Being male increases the risk of developing kidney disease by 2 times.
2. Smoking. The risk of developing the disease doubles.
3. Excess body weight increases the risk of developing kidney cancer by 20%.
4. Arterial hypertension.
5. Diabetes.
6. Viral infections.
7. Harmful working conditions.
8. Genetic predisposition (von Hippel-Lindau syndrome, familial papillary cancer, familial clear cell renal cell carcinoma).

Diagnosis of kidney cancer

First of all, a consultation with a doctor is required, who, based on the examination and complaints of the patient, selects research methods.

Diagnostics includes both laboratory tests and instrumental methods.

• General and biochemical analysis of blood and urine;
• electrocardiogram;
• Ultrasound of the kidneys;
• CT scan of the abdominal cavity;
• radiography.

To clarify the diagnosis, the patient may be referred to:

• angiography of renal vessels;
• scintigraphy;
• MRI.

If cancer cells are detected, the doctor may order a histological examination of a tissue sample.

How is diagnosis done?

Based on the patient’s complaints, the doctor will find out the history of kidney cancer and draw up an examination plan. It includes not only laboratory tests for kidney cancer, but also special instrumental methods. Laboratory methods include:

• general and chemical urine analysis for cancer;
• blood analysis;
• electrocardiogram.

Instrumental diagnosis of kidney cancer consists of:

• Ultrasound of the kidneys. Using ultrasound examination of the abdominal organs, a distinctive analysis is carried out between malignant formation and non-tumor pathology. An ultrasound shows the situation in the renal vein (the presence of blood clots), and they are checking for the presence of metastases.
• CT scan of the peritoneum. A more detailed examination method that allows you to accurately determine the volume, location, and presence of metastases in the internal organs.
• Radiography. Using a chest x-ray, the presence of metastases in the lymph nodes and lungs is checked.

Based on the results of instrumental diagnostics, clarifying examination methods may be prescribed:

• X-ray of blood vessels. Blood circulation in large tumors is studied.
• Functional imaging (scintigraphy). Using a radioactive component, the functionality of the organ is studied.
• MRI or CT scan of the human brain and skeleton. A CT or MRI shows a hypodense focus, the extent of the spread of malignant cells in the body.

• General clinical and biochemical blood tests. Helps determine the general health of the patient and the presence of inflammatory processes in the body. The material is also used in research on tumor markers.
• Chemical and general urine analysis. Detects tumor markers in urine and gives an idea of ​​the general biological indicators of the body.
• Ultrasound. Ultrasound examination determines where the hypodense lesion is located and its size. Ultrasound also shows the condition of the vessels around the tumor, which is necessary to avoid thrombosis. During the procedure, the doctor takes a biopsy, based on which the histology of the tumor is determined.
• CT scan of the abdomen. Determines the exact location of the tumor and the presence of metastases.
• Nephroscintigraphy. Evaluates the functional state of the organ.
• Excretory urography. X-ray examination with the introduction of a contrast agent.

If there is a suspicion that a patient has kidney cancer, the doctor will order a series of diagnostic tests. Based on the data obtained, a diagnosis is made. This is a necessary condition for determining effective treatment tactics for malignant kidney tumors.

Before conducting research, the doctor examines the patient and interviews him in detail. Finds out when the first complaints appeared, and what nature they were, which of them arose first, and which later.

• Kidney ultrasound

At this time, kidney ultrasound is the standard for diagnosing kidney diseases of various types. Using this method, the structure of the neoplasm, its location, relationship with other organs, and size are determined. Ultrasound helps identify regional and distant metastases.

• X-ray examination

If kidney cancer is suspected, excretory contrast urography is performed. Before the procedure, the patient is injected intravenously with a contrast agent, which enters the kidneys through the bloodstream. After a short period of time, X-ray images of the kidney area are taken. Urography allows you to evaluate the excretory function of the kidneys and the condition of the ureters.

Renal angiography refers to x-ray diagnostic methods. During this examination, a contrast agent is injected into the aorta above the place where the renal arteries arise from it. With the blood flow it enters the kidney tissue, this allows the tumor to be visualized.

Computed tomography and magnetic resonance imaging are highly sensitive x-ray methods for layer-by-layer examination of organs. They make it possible to establish the localization of the tumor process, as well as the degree of its prevalence, and are used as additional diagnostic methods.

A biopsy allows you to reliably determine the nature of the neoplasm. The examination is carried out under local anesthesia and under ultrasound or CT control. In this test, a small piece of tissue is taken using a needle that is inserted into the kidney area.

After this, a histological examination of the tissue fragment is carried out, which makes it possible to establish a diagnosis and determine the type of tumor. A kidney biopsy can cause complications: bleeding, infection of the puncture site, and spread of tumor cells in the area where the needle was inserted.

It should be noted that a kidney biopsy for suspected cancer is performed in rare cases, this avoids complications. It is performed if the likelihood of having a benign neoplasm is higher than that of a malignant one, or if the patient refuses surgical intervention.

Additional methods for diagnosing kidney cancer are: radiography of the lungs (it is used to detect distant metastases), radioisotope scanning of bone tissue (detection of metastases in the bones), laboratory testing of urine and blood.

Treatment

If a malignant tumor is detected in the kidneys, treatment must be started immediately. It is known that the earlier cancer is diagnosed, the more favorable the patient’s prognosis for recovery.

There are two main types of treatment:

After all the examinations, the doctor determines the most effective and least traumatic method.

Conservative treatment

Once the diagnosis is confirmed, treatment should begin immediately. In the early stages of tumor development, preference is given to conservative therapy.

The same method is used if the cancer is inoperable, as well as after surgery.

This treatment method does not require a constant stay in the hospital. The patient often visits the day hospital.

Conservative treatment includes the following areas:

1. Chemotherapy. The patient is injected with special substances that suppress the growth of malignant cells. Treatment is often ineffective, and in case of relapse of the disease it is almost completely useless.
2. Radiation therapy. Most often used after surgery. The affected areas are irradiated with X-rays or gamma rays. In inoperable cases, as well as in the presence of metastases, this method helps to alleviate the symptoms of the disease. There are external and intracavitary therapy. It is not used as an independent method of treatment.
3. Immunotherapy. It is used to activate the immune system aimed at fighting malignant neoplasms. Most effective for clear cell cancer. Ineffective for sarcoma.
4. Targeted therapy. A new way of treatment. With its help, tumor growth is blocked.

In addition, there are various folk methods, but their effectiveness has not been proven.

Surgery

Kidney surgery gives the patient the highest chance of successfully fighting the disease.

The choice of surgical intervention depends on the type of cancer and its stage of development.

The following types of surgical intervention are distinguished:

1. Removal of an organ. Radical method. Most often it is used if the tumor size is more than 7 cm and it has already spread to nearby tissues. Not only the kidney itself is removed, but also nearby fatty tissue, lymph nodes and, very often, the adrenal gland.
2. Organ resection. Removal of the tumor and part of the organ. Less traumatic way. Used for small tumors localized exclusively in the kidney tissue.

Stages of development of the disease and its varieties

Renal cell carcinoma goes through 4 stages of development. The TNM system represents a description of oncology: the letter T indicates the fact of a neoplasm. N – reflects the involvement of lymph nodes in metastasis. M – characterizes metastasis. The course of renal cell oncology is divided into stages:

Stage 0 – the size of the tumor is small, it is impossible to detect it using laboratory diagnostic tools. Otherwise, stage is called g1 - tumor cells differ little from healthy ones.

Stage 1 – the cancer process begins to progress. The tumor is up to 7 cm in diameter. This is stage g2, the degree of the pathological process is average.

Stage 2 – tumor size is from 7 to 10 cm. The neoplasm is located in the kidney tissue. There are no metastases. This is stage g3, cancer cells look specific.

Stage 3 – the tumor grows, but does not extend beyond the renal capsule. This is stage g4, in which cancer cells differ sharply from healthy tissue.

Stage 4 – cancer spreads by metastases to the lymph nodes, disrupting the contours of the kidney capsule. This is the last step in the development of the disease. This is stage gx, there are already more cancer cells than healthy ones.

Forecast

Chromophobe kidney cancer is a serious disease, the consequences of which will be felt for the rest of your life.

The patient's survival in this case depends on many factors. This includes the patient’s age, his general condition, and the presence of other diseases, as well as complications. The stage of cancer at the time of diagnosis is of great importance. For example, at stage 4, the probability of a favorable outcome tends to zero.

However, don't lose hope. Removing the organ gives the patient several extra years of life.

In all other cases, the mortality rate reaches 70%.

Prognosis for kidney carcinoma

The prognosis for survival with renal carcinoma directly depends on the stage at which the pathology was detected. So, in the first stage the probability of complete recovery is 81%, in the second – 74%, in the third – 53%, and in the fourth – only 8%.

In 53% of cases, provided the treatment is received, patients live 5 years, in 43% - 10 years. If left untreated, metastases will cause necrosis and severe intoxication of the body. At the final stage, failure of all organs and systems occurs.

3 minutes to read

Chromophobe kidney cancer is considered a rather rare form of the disease and is detected in 4-10% of cases. A malignant tumor forms from the medulla of the kidney and is most often diagnosed in the initial stages. The neoplasm rarely extends beyond the capsule and the formation of metastases does not occur very often. By removing the foci of the pathological process, chromophobe kidney cancer can be cured.

Content

Prevention

Since the mechanisms of kidney cancer development have not been sufficiently studied, doctors first of all recommend taking care of your health and leading a healthy lifestyle. Known risk factors should be taken into account and efforts should be made to avoid them.

Annual medical examination also plays an important role, allowing the disease to be identified at an early stage.

If any symptoms of illness appear, you should immediately consult a doctor.

Clarification of the immunohistochemical type of tumor helps to choose the right treatment tactics. Chromophobe kidney cancer is a prognostically favorable variant of a malignant neoplasm, in which the risk of metastasis is minimal and the chances of complete recovery are maximized.

Signs of a renal cell tumor

The onset of kidney disease is asymptomatic. Primary signs of a pathological process in an organ:

• there are thread-like blood formations in the urine;
• discomfort in the lower back;
• compaction in the kidneys, detected by palpation.

If any of the above symptoms occur, you should immediately consult a doctor. If you postpone a visit to a medical facility, these symptoms will soon be supplemented by constant aching pain in the lower back, causeless fever, malaise, fatigue, and weight loss.

Rare cancer histotype

One of the variants of renal cell cancer of the main urinary organ is chromophobe kidney carcinoma, which occurs in 4-6% of cases. When conducting a special histochemical study, the cells of the removed tumor are not stained with a specific dye, which indicates low activity of the tumor tissue. The main cause of cancer in the renal parenchyma is a hereditary factor caused by genetic mutations. Features of the chromophobe subtype of cancer include:

• slow growth;
• frequent combination with oncocytoma and the formation of a mixed variant of the neoplasm;
• low risk of distant metastases.

Detection of any tumor in the kidney area is a negative factor for health. Carrying out a complete diagnosis and choosing the optimal treatment option will save life and ensure that a person is freed from a dangerous pathology.

Features of the pathology

Chromophobe kidney carcinoma is considered one of the variants of renal cell cancer, and it develops in the body for various reasons. There is low activity of the tumor tissue, therefore, during a special histochemical study, the cells are stained with a specific dye.

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Experts highlight the following features of the chromophobe subtype of cancer:

• slow growth;
• low probability of formation of distant metastases;
• frequent combination with oncocytoma and the development of a mixed variant of the tumor.

The tumor poses a serious threat to human health. It is necessary to conduct a thorough diagnosis, based on the results of which it is important to select the optimal treatment option. Timely treatment allows you to get rid of a dangerous disease and save a person’s life.

Treatment tactics

Surgical removal of the tumor is the only possible option at the first stage of therapy: nephrectomy ensures that a person is freed from a growing malignant tumor and a full examination of the removed tumor tissue is carried out in the laboratory. During the operation, the doctor will completely remove the cancerous kidney along with the perinephric tissue and nearby lymph nodes. Immunohistochemical examination is mandatory - cellular diagnostics are needed for the correct choice of further treatment and prediction of metastatic complications. For the chromophobic type, the oncologist will prescribe additional treatment factors:

• immunotherapy;
• chemotherapy treatment;
• targeted drugs;
• radiation exposure (according to strict indications).

For each sick person with cancer of the kidney tissue, treatment is selected individually.

Causes of renal cell malignancy

There is no list of exact causes that are guaranteed to lead to cancer. However, scientists have identified factors that help the development of the disease:

• smoking and alcoholism;
• excessive consumption of red meat;
• excess body weight;
• hormonal imbalances in the body;
• diabetes;
• inflammatory disease of the genitourinary system;
• arterial hypertension;
• uncontrolled use of phenacetin as an anesthetic;
• exposure to radioactive rays;
• polycystic kidney disease as a result of hemodialysis therapy;
• genetic predisposition;
• kidney injuries;
• work in hazardous industries associated with exposure to asbestos, radiopaque and leather tanning substances.

Predicting treatment outcomes

The following factors increase your chances of survival:

• stage of the oncological process;
• prognostically positive immunohistochemical examination result;
• absence of metastases.

Chromophobe kidney cancer detected in the early stages, the prognosis of which is favorable, with the right approach to combination therapy and long-term observation by an oncologist, is a real chance to completely get rid of the cancer with a low risk of dangerous complications.

Complications

Most often, complications occur as the tumor progresses. They can arise from the tumor itself, from treatment of the tumor, or from metastasis.

Most complications occur extremely rarely and only a small number of patients experience them.

Complete hematuria

This is the most common complication. Completely bloody urine is rare as the first symptom, but in advanced stages it occurs in almost half of patients.

High blood pressure

The kidneys play an important role in regulating blood pressure. Kidney cancer can lead to persistent high blood pressure and sometimes blood pressure that is very difficult to control (malignant hypertension).

Hypercalcemia

Elevated calcium levels in the blood can occur either due to paraneoplastic syndrome or due to bone destruction with bone metastases. High levels of calcium in the blood due to cancer (hypercalcemia) can lead not only to symptoms such as nausea, but also severe muscle weakness, confusion, coma, and even death. However, this condition is treatable if diagnosed early.

High red blood cell count

A high number of red blood cells (erythrocytosis) is characteristic of advanced stages of renal oncology. In the early stages, on the contrary, anemia is usually observed. Erythrocytosis occurs due to cancer cells producing a protein that stimulates the bone marrow. Excess red blood cells, in turn, can increase the risk of blood clots, heart attacks and strokes because the blood becomes “thicker” (more viscous).

Complications of treatment

Treatment for kidney cancer may involve removing part or all of the kidney. This is a major surgical procedure that can lead to adverse cardiac events, stroke, pulmonary embolism (a clot in the leg ruptures and travels to the lungs), pneumonia, or injury during surgery. Infections in the abdomen and bleeding may also occur.

Surgery is evolving and there are far fewer complications now than in the past, especially with less invasive surgical options such as laparoscopic nephrectomy (removal of the kidney through small incisions in the abdomen and special instruments).

Kidney failure

Because surgery often involves removing the entire kidney, or at least part of it, only one functioning kidney remains. Additionally, certain treatments as well as medications can stress the remaining organ, leading to kidney failure.

Chromophobe carcinoma. Chromophobe renal cell carcinoma. 8317/3

This type of cancer is characterized by large, pale, polygonal cells with prominent cell membranes.

Makes up approximately 5% of epithelial kidney tumors.

The average age of patients is in the sixth decade of life.

The mortality rate is less than 10%. Chromophobe kidney cancer can be sporadic and hereditary. As a rule, the tumor is solid, round in shape, lobular in appearance, and light brown in color.

Most chromophobe carcinomas are detected at stage T1-T2 (86%), only in 10% of cases the tumor grows beyond the kidney capsule, and only in 4% does the renal vein become involved. A few observations describe lymphogenous and distant metastases (lungs, liver, pancreas).

The tumor is represented predominantly by solid fields of light large cells, which can form tubulocystic structures or solid nests in the edematous stroma. The vessels in the focus of chromophobe renal cell carcinoma are mainly of medium caliber, in contrast to the small sinusoidal capillaries of clear cell carcinoma.

Two types of chromophobe carcinoma cells can be distinguished: large polygonal chromophobe cells with light, abundant cytoplasm, distinct cell walls (resembling the cell wall of plants) and smaller ones with less cytoplasm. The combination of these cell types characterizes the classic version of chromophobe cancer (Fig. 1.20-1.22).

Symptoms of pathology

There are two types of chromophobe carcinoma cells.

Large polygonal chromophobic cells, which are characterized by abundant light cytoplasm, have well-defined cell walls. In addition, there are smaller chromophobe cells with less cytoplasm. The combination of these two types of cells leads to the development of the classic variant of chromophobe kidney cancer.

Tumors that contain cells with clearly eozonophilic cytoplasm are considered an eozonophilic variant of a chromophobe tumor.

Oncological damage to the kidney may not cause pronounced symptoms, especially at the very beginning of its development. Symptoms of the disease become noticeable already when the tumor reaches an impressive size and metastasizes to neighboring tissues and organs.