NEOPLASMS OF THE KIDNEY

NEOPLASMS OF THE KIDNEY : Dr.Abdulrazzaq Al-Salman
Benign neoplasms 1- Adenoma
2- Angioma
3- Angiomyolipoma
Malignant neoplasms
1- Wilms’ tumour (nephroblastoma in children)
2- Grawitz’s tumour (adenocarcinoma, hypernephroma).
3-Transitional cell carcinoma of the renal pelvis .
4- Squamous carcinoma of the renal pelvis
Benign neoplasms
Adenoma:Pea-like cortical adenomas are discovered incidentally during radiological imaging. They are asymptomatic .

Angioma:Angioma may cause profuse haematuria, often in young dults.
The source of the bleeding may be difficult to diagnose without renal angiography.
Angiomy olipoma:Angiomyolipoma is an unusual tumour of the kidney that is often but not always associated with tuberous sclerosis. Its high fat content gives it a typical appearance on CT. Malignant elements are present in about one-quarter of them and may lead to metastasis.

Malignant neoplasms
Renal neoplasm in children
Nephroblastoma (Wilms’ tumour):
It s a mixed tumour containing blastemal, stromal and epithelial elements arising from embryonic nephrogenic tissue. Usually discovered during the first 5 years of life, usually in one pole of one kidney.
Pathology The cut surface of the tumour is tan coloured,soft and friable in consistency.
Clinical features: (mass, hematuria, pain ,fever)
Typically presents with an abdominal mass. May cause haematuria, abdominal pain or fever. Some patients are hypertensive.Haematuria denotes extension of the tumour into the renal pelvis and the prognosis is less good.
Investigations:(US, CT, MRI)
Ultrasonography, CT or magnetic resonance imaging (MRI) confirms a solid space-occupying lesion in the kidney,with or without venous invasion, contralateral disease and distant spread.
Spread::x 71.28
Metastasis to the lungs occurs early. Liver, bone and brain metastases are rare. Lymphatic spread is uncommon.