Urology
David A Lisle in Imaging for Students, 2012
Computed tomography (CT) urography is the investigation of choice for painless haematuria. CT urography is a term used to describe a contrast-enhanced CT technique designed to provide excellent delineation of the renal collecting systems, ureters and bladder, as well as cross-sectional images of the kidneys and adjacent structures. Contrast-enhanced CT is used for further characterization of a solid lesion or complex cyst found on ultrasound (US). CT is more accurate than US for characterization of internal contents of a mass, in particular to show areas of fat confirming the diagnosis of Angiomyolipoma. The most common CT appearance of renal cell carcinoma is a heterogeneous soft tissue mass that enhances with intravenous contrast material. In some centres, magnetic resonance imaging is used in preference to CT for the investigation and characterization of renal masses. Magnetic resonance imaging generally gives similar information to CT in the detection, classification and staging of renal cysts and tumours.
Renal Cell Cancer
Pat Price, Karol Sikora in Treatment of Cancer, 2020
In 1960, on the basis of electron microscopic features, C. Oberling et al. demonstrated a proximal renal tubular origin, and tumors were renamed renal cell adenocarcinoma or renal cell carcinoma (RCC). Macroscopically clear-cell RCCs have a characteristic appearance with solid areas often interspersed with areas of cystic degeneration. A number of hereditary syndromes are associated with the development of kidney cancer, which tends to present at a younger age with multifocal or bilateral disease. A number of risk factors have been implicated in the development of RCC, including increasing age, cigarette smoking, obesity, and hypertension. The chronic use of analgesics appears to be contributory to the development of RCC in addition with acetaminophen, and non-aspirin non-steroidal anti-inflammatory drugs suggested as the causative agents. Historically surgical removal of the involved kidney in patients presenting with metastatic RCC was undertaken for palliation of symptomatic primary tumors.
Urological cancer
Peter Hoskin in Clinical Oncology, 2020
This chapter deals with urological cancer, focusing on renal cell carcinoma, prostate cancer, bladder cancer, testicular cancer, and penis cancer. It discusses aspects of epidemiology, aetiology, pathology, symptoms and sings, diagnosis and investigations, various types of therapies and treatments, and complications of the five types of cancers. For renal cell carcinoma, radical nephrectomy in which the perirenal fat, perirenal fascia, adrenal gland and regional nodes are removed en bloc is the operation of choice with superior local control rates to simple nephrectomy. In testicular cancer, all patients will proceed to inguinal orchidectomy with removal of the affected testis. Scrotal interference should be avoided at all costs because of the risk of tumour implantation in the scrotal wound and subsequent relapse.
Neoadjuvant treatment in advanced renal cell carcinoma: current situation and future perspectives
Published in Expert Review of Anticancer Therapy, 2012
Marc-Olivier Timsit, Laurence Albiges, Arnaud Méjean, Bernard Escudier
Neoadjuvant approaches in renal cell carcinoma are currently under investigation, following the demonstration of targeted therapy efficacy in the metastatic setting. It raises the issues of downsizing locally advanced or nonresectable tumor and offering organ-sparing surgery, saety and its potential role in early micrometastatic disease. Relevant studies of the neoadjuvant setting in renal cell carcinoma with targeted therapies were identified from the literature, clinical trial databases and conference abstracts. To date, a neoadjuvant approach appears feasible in terms of saety. Currently available drugs do not achieve major tumor downsizing with primary tumor diameters response rate of 10%. Neoadjuvants should only be considered in clinical trials or as a litmus test in locally advanced patients.
Leptomeningeal Metastases in Renal Cell Carcinoma at Initial Diagnosis: 2 Case Reports and Literature Review
Published in Cancer Investigation, 2019
Manel Dridi, Wafa Bouleftour, Romain Rivoirard, Pierre Dal Col, Julien Langrand-Escure, Cécile Vassal, Aline Guillot
Leptomeningeal metastasis (LM) in solid tumors are rare, even more in renal cell carcinoma (RCC). To date there is a lack of consensual treatment modalities of leptomeningeal metastasis. Furthermore, with the improvement of outcomes and more effective systemic targeted therapies, the management of leptomeningeal metastasis becomes a real challenge. We here report two cases of RCC with leptomeningeal metastasis at initial diagnosis. Both patients had concurrent adjacent skull bone metastasis. Therapeutic management of both patients consisted in surgical resection, followed by radiotherapy in one case. Systemic treatment was delayed according to current recommendations for the management of metastatic RCC. The aim of this work is to report the therapeutic approach and related outcomes and also provide a review of the currently available literature on leptomeningeal disease in renal cell carcinoma. Indeed, local treatment with curative outcome of meningeal location in RCC should be performed specially in LM at initial diagnosis.
Emerging therapeutic approaches in renal cell carcinoma
Published in Expert Review of Anticancer Therapy, 2015
In the past decade, targeted therapy with VEGF and mTOR inhibition has significantly improved the outcome of renal cell carcinoma. However, the management of metastatic renal cell carcinoma still remains challenging as most patients eventually progress on targeted therapy, and long-term survivors are still relatively uncommon. There has recently been a resurgence of interest in cancer immunotherapy with the development of checkpoint inhibitors. Here we discuss the best methods to optimize the current standard of care with targeted therapy, and describe select emerging targeted therapies and immunotherapies with anti programmed death-1 pathway inhibitors in the management of metastatic renal cell carcinoma.
Related Knowledge Centers
- Adenocarcinoma
- Kidney Cancer
- Kidneys
- Nephrectomy
- Proximal Tubule
- Kidney Neoplasms
- Kidney