nonpapillary renal cell carcinoma

Non-papillary renal cell carcinoma (RCC) refers to a type of kidney cancer that does not fall under the papillary category. This group of cancers is heterogeneous and encompasses multiple histologies with different molecular features.

• Non-clear cell RCC, in particular, is an umbrella term for a diverse subset of tumors, each with unique characteristics [6].
• It consists of several subtypes, including chromophobe, translocation, medullary, collecting duct, unclassified, and other rare types [10].
• These cancers are often characterized by their poor prognosis and lack of clear cell features [1].

It's worth noting that non-papillary RCC is a broad term that encompasses various histological subtypes, each with its own distinct characteristics. Further research and classification are needed to better understand the nuances of these cancers.

References: [1] - Context result 1 [6] - Context result 6 [10] - Context result 10

Nonpapillary renal cell carcinoma, also known as clear cell renal cell carcinoma, can exhibit a range of signs and symptoms. Some of the most common ones include:

• Blood in urine: This is one of the most distinctive symptoms of nonpapillary renal cell carcinoma, where patients may notice blood or hematuria in their urine [2][7].
• Back pain: Pain in the back or side can be a symptom of this type of cancer, often on one side of the body [2][5].
• Unintentional weight loss: Patients with nonpapillary renal cell carcinoma may experience unexplained weight loss due to the tumor's impact on their overall health [3][7].
• Fatigue: Feeling tired or exhausted can be a symptom of this type of cancer, as the body struggles to cope with the disease [3][6].
• Fever: Some patients may develop a fever as a result of the cancer's progression [3][6].

It's worth noting that not all patients will exhibit these symptoms, and some may experience other signs or none at all. If you're concerned about your health or suspect you might be experiencing symptoms related to nonpapillary renal cell carcinoma, it's essential to consult a medical professional for proper evaluation and diagnosis.

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Diagnostic Tests for Nonpapillary Renal Cell Carcinoma

Nonpapillary renal cell carcinoma (RCC) is a type of kidney cancer that accounts for the majority of cases. Diagnosing this condition typically involves a combination of physical examination, medical history, and various imaging tests.

• Imaging Tests: Contrast-enhanced computed tomography (CT) scans are commonly used to diagnose and stage nonpapillary RCC [5]. CT scans can help identify tumors and assess their size, location, and spread. Magnetic resonance imaging (MRI) scans may also be used in some cases [9].
• Blood and Urine Tests: Blood tests can measure levels of creatinine, hemoglobin, leukocyte count, platelet count, lymphocyte to neutrophil ratio, lactate dehydrogenase, and other biomarkers that may indicate the presence of RCC [8]. Urine tests can also be used to detect blood or other abnormalities in the urine.
• Physical Examination: A physical exam can help identify symptoms such as pain, weight loss, fatigue, fever, or a lump in the side [7].
• Multi-phasic Contrast-Enhanced CT Scans: These scans are recommended for diagnosing and staging renal tumours, including nonpapillary RCC [2].

It's worth noting that while these tests can help diagnose nonpapillary RCC, a definitive diagnosis often requires a biopsy. However, the decision to perform a biopsy is typically made on a case-by-case basis.

References: [1] Gray RE (2019) - Further laboratory evaluation includes assessment of urinary sediment, creatinine, C-reactive protein, hemoglobin, erythrocyte sedimentation... [2] Use multi-phasic contrast-enhanced computed tomography (CT) of abdomen and chest for the diagnosis and staging of renal tumours. [3] CT and MRI scans are usually the only tests doctors need to diagnose kidney cancer. Sometimes, though, doctors perform what's known as a percutaneous biopsy. [4] Aug 17, 2024 - Kidney cancer diagnosis often begins with a physical exam and a discussion of your health history. Blood and urine tests as well as imaging tests may be used. [5] Mar 21, 2023 - Contrast-enhanced CT scanning has become the imaging procedure of choice for diagnosis and staging of renal cell cancer. [6] Apr 17, 2023 - Tests done to diagnose renal cell carcinoma​​ Providers use imaging tests to identify tumors and plan treatment. The most common tests include: [7] Mar 17, 2020 - How is ccRCC diagnosed? · Blood in the urine · Pain · Weight loss · Feeling tired · Fever · A lump in the side. [8] Escudier B (2019) - Suspicion of RCC should prompt laboratory examinations of serum creatinine, haemoglobin, leukocyte and platelet counts, lymphocyte to neutrophil ratio, lactate... [9] May 1, 2024 - Imaging tests such as computed tomography (CT) scans and magnetic resonance imaging (MRI) can often find small kidney cancers. But these tests...

Treatment Options for Non-Papillary Renal Cell Carcinoma

Non-papillary renal cell carcinoma (RCC) accounts for the majority of RCC cases, and treatment options have evolved over the years. Here are some key points to consider:

• Immunotherapy: Immunotherapies such as nivolumab plus ipilimumab [2] and lenvatinib plus pembrolizumab [2] have shown promise in treating non-papillary RCC.
• Targeted Therapy: Targeted drugs like cabozantinib, nivolumab, and ipilimumab combination may be effective in treating patients with genitourinary tumors that have no treatment options [9].
• Multikinase Inhibitors: Lenvatinib and cabozantinib are multikinase inhibitors approved for the treatment of non-papillary RCC [3].
• Adjuvant Treatment: Pembrolizumab has been approved as an adjuvant treatment for patients at high risk for recurrence after nephrectomy based on the KEYNOTE-564 trial [1].

Key Points to Consider

• Immunotherapy and targeted therapy are emerging as effective treatment options for non-papillary RCC.
• Multikinase inhibitors like lenvatinib and cabozantinib have shown promise in treating this type of cancer.
• Adjuvant treatment with pembrolizumab may be beneficial for patients at high risk for recurrence.

References

[1] JT Brown · 2024 - Pembrolizumab was approved as adjuvant treatment for patients at high risk for recurrence after nephrectomy based on the KEYNOTE-564 trial. [2] TK Choueiri — Approach to therapy · Preferred immunotherapy regimens · - Nivolumab plus ipilimumab · - Lenvatinib plus pembrolizumab [3] T Zhang · Cited by 31 — Over the past 2 years, three new treatments have been introduced for metastatic RCC—the multikinase inhibitors lenvatinib and cabozantinib were approved, as ... [9] Giving cabozantinib, nivolumab, and ipilimumab may work better in treating patients with genitourinary tumors that have no treatment options compared to giving ...

Differential Diagnoses for Non-Papillary Renal Cell Carcinoma

Non-papillary renal cell carcinoma (RCC) is a type of kidney cancer that does not belong to the papillary subtype. The differential diagnoses for non-papillary RCC include various subtypes and types of kidney cancers, which can be challenging to differentiate based on histomorphologic features alone.

Main Differential Diagnoses:

• Clear Cell Renal Cell Carcinoma (ccRCC): This is the most common subtype of RCC, accounting for approximately 70-80% of all RCC cases. It is characterized by clear cells and can be aggressive in nature [8].
• Chromophobe Renal Cell Carcinoma: This subtype accounts for about 5% of RCC cases and is typically composed of large, pale cells with a characteristic "chicken wire" appearance under the microscope.
• Collecting Duct Carcinoma: A rare and aggressive subtype of RCC that arises from the collecting ducts of the kidney.

Less Frequent Differential Diagnoses:

• Xp11 Translocation Renal Cell Carcinoma: A rare subtype of RCC characterized by a specific genetic translocation involving the X chromosome.
• Clear Cell Papillary Renal Cell Carcinoma: A rare subtype that combines features of clear cell and papillary RCC.

Key Diagnostic Features:

• Histomorphologic examination is crucial in differentiating these subtypes, with each having distinct cellular and architectural features [2].
• Immunohistochemistry can also be used to aid in diagnosis, particularly for distinguishing between clear cell and chromophobe RCC.
• Molecular genetic analysis may be necessary to confirm the diagnosis of Xp11 translocation RCC.

References:

[1] Sirohi D. (2018) - This review focuses on the histomorphologic diagnostic challenges of unclassified RCCs discussing the utility of contemporary diagnostic tools [2]. [3] Athanazio DA. (2021) - Other rather less frequent differential diagnosis would include collision tumors showing a papillary tumor and conventional clear cells, ... [4] Pandey J. (2022) - It is possible to differentiate the three main subtypes (clear cell, papillary, and chromophobe) based on characteristic radiologic appearances ... [5] Ross H. (2012) - The 4 main neoplasms in the differential diagnosis are clear cell RCC, papillary RCC, clear cell papillary RCC, and Xp11 translocation RCC. [6] Williamson SR. (2013) - Molecular-genetic changes are distinct from those of clear cell and papillary renal cell carcinomas: Alterations of chromosome 3p and the VHL ... [7] Williamson SR. (2013) - Of these, the original diagnoses included: clear cell renal cell carcinoma (341 tumors); papillary renal cell carcinoma (72 tumors); chromophobe renal cell ...