Kidney Tumors

Kidney tumors can range from a cyst to a solid growth originating from within the renal tissue. Most kidney tumors are discovered during an imaging study such as an ultrasound or a CAT scan that was ordered for another reason.

Renal cysts are very common and half of the population over the age of fifty years old will have at least one. Less commonly, renal cysts can be passed on from generation-to-generation and one such condition is known as polycystic kidney disease.

The two classes of renal cysts are simple and complex.

• Simple Renal Cysts: Usually a fluid collection surrounded by a narrow wall of tissue. Most simple cysts do not need routine surveillance, as they do not usually become cancerous. However, larger renal cysts can occasionally create abdominal and/or back pain and they can be drained and sclerosed percutaneously or laparoscopically.
• Complex Renal Cysts: Usually also containing fluid, but may occasionally be thicker than the fluid found in a simple cyst. A complex cyst may also have a wall that is irregularly thick with additional tissue and/or calcification as well as internal septation (becoming separated). Complex cysts usually need to be monitored regularly as they have the potential of becoming cancerous.

• If a kidney tumor is suspected to be “solid” in nature, then an imaging workup is usually required to see if it “enhances” when radiographic contrast is given. This is done to determine if an individual’s renal function is adequate.
• The most common study for kidney tumors is a CAT scan of the abdomen and pelvis with and without contrast. Other options can also include an MRI with contrast, a renal ultrasound.
• When a kidney tumor enhances with a contrast study, the likelihood of it being cancerous in nature is very high. In most cases, only the imaging study is needed before moving forward with treatment.
• Rarely, but occasionally needed, is a biopsy of the kidney tumor.

• For solid tumors, depending on the size, location, and or stage of the disease, either the entire kidney or just the tumor will have to be removed.
• Depending on the stage of the patient, either an open or laparoscopic procedure will be recommended.
• Other alternatives to the management of renal tumor may include either cryoablation or radio-frequency ablation.
• During the last decade, the use of the Intuitive da Vinci surgical system has also become more popular as the concept of renal preservation surgery has become more common.

For patients suffering from early stage of renal cell carcinoma, surgical intervention is usually the first line of treatment. However, in more advance disease, those patients may receive oral chemotherapy and/or immune therapy.