renal pelvis adenocarcinoma

Renal Pelvis Adenocarcinoma: A Rare and Aggressive Form of Cancer

Renal pelvis adenocarcinoma is a rare and aggressive form of cancer that affects the renal pelvis, which is the part of the kidney that collects urine and drains it to the ureters. This type of cancer is also known as primary mucinous adenocarcinoma of the renal pelvis.

Incidence and Demographics

Primary adenocarcinoma of the renal pelvis or ureter is a very rare condition, accounting for less than 1% of all renal and ureteral epithelial tumors [3]. The exact incidence of this cancer is not well-documented, but it is estimated to be extremely uncommon.

Symptoms and Diagnosis

The symptoms of renal pelvis adenocarcinoma can vary depending on the stage and location of the tumor. Common symptoms include:

• Blood in the urine (hematuria)
• Back pain
• Cramping or discomfort in the lower back

Diagnosis is typically made through imaging studies, such as CT scans or MRI, which show a mass in the renal pelvis or ureter [4]. Biopsy and histopathological examination of the tumor tissue are also used to confirm the diagnosis.

Treatment Options

Treatment for renal pelvis adenocarcinoma usually involves surgery, including nephroureterectomy (removal of the kidney and ureter) [5]. In some cases, chemotherapy or radiation therapy may be recommended as an adjunct to surgery. The prognosis for this cancer is generally poor, with a high risk of recurrence and metastasis.

References

[1] by S Agrawal · 2021 · Cited by 5 — Primary adenocarcinoma of renal pelvis or ureter is very rare and urologists should suspect it in patients with mucinous material in nephrostomy tube. [3] by F Khan · 2023 — Primary renal adenocarcinomas comprise of less than 1% of renal and ureteral epithelial tumors. [4] by B Han · 2021 · Cited by 4 — Primary mucinous adenocarcinoma of renal pelvis is an extremely uncommon malignant tumor without typical clinical manifestations and imaging characteristics. [5] by W Gazzah · 2024 — Primary adenocarcinoma of the renal pelvis is a rare and unique malignancy, representing a small fraction of renal cancers and posing significant diagnostic challenges.

Based on the available information, here are the typical signs and symptoms of Adenocarcinoma of Renal Pelvis:

• Blood in urine (hematuria) [12]
• A lump on the side of the abdomen [12]
• Flank pain [12]
• Unexplained fever [12]
• Unexplained weight loss [12]

Additionally, complications such as the spreading of cancer to other parts of the body can also occur.

It's worth noting that early kidney cancers often don't cause any signs or symptoms, but larger or more advanced ones might. Some possible signs and symptoms of kidney cancer include:

• Blood in the urine (hematuria) [13]
• Low back pain on one side (not caused by injury) [13]
• A mass (lump) on the side or lower back [13]
• Fever that is not caused by an infection and that doesn’t go away [13]

It's also important to note that metastatic kidney cancer can cause symptoms in the newly affected areas of the body, including:

• Symptoms such as bone pain, neurological problems, or other systemic symptoms may occur depending on where the cancer has spread [15]

Renal pelvis adenocarcinoma, also known as transitional cell cancer of the renal pelvis and ureter, can be diagnosed using various tests.

Imaging Tests

• Computed Tomography (CT) scans are often used to diagnose renal pelvis adenocarcinoma. They help doctors distinguish other conditions that may cause similar symptoms [3].
• Magnetic Resonance Imaging (MRI) scans may also be used to diagnose this type of cancer, especially if a CT scan is inconclusive [5].
• Ultrasound tests can also be used to examine the abdomen and kidneys, which can help in diagnosing renal pelvis adenocarcinoma [13].

Lab Tests

• Urinalysis may show blood in the urine, which can indicate the presence of cancer cells [4].
• A complete blood count (CBC) may show anemia, which can be a sign of advanced cancer [4].
• Urine cytology (microscopic examination) can also be used to diagnose renal pelvis adenocarcinoma by examining cells in the urine for abnormal changes [7].

Other Tests

• Percutaneous biopsy may be performed if imaging tests suggest the presence of cancer. This involves taking a sample of tissue from the affected area using a needle [5].
• A renal scan and PET scan may also be used to diagnose renal pelvis adenocarcinoma by revealing abnormalities in the kidney or surrounding tissues [6].

It's worth noting that diagnosis is often made through a combination of these tests, rather than relying on a single test. Healthcare providers will work with patients to determine the best course of action for their specific situation.

References: [3] - The cancer is usually detected by using computed tomography (CT) or ultrasonography. [4] - Exams and Tests · Urinalysis may show blood in the urine. · A complete blood count (CBC) may show anemia. [5] - Percutaneous biopsy may be performed if imaging tests suggest the presence of cancer. [6] - Transitional cell cancer of the renal pelvis and ureter treatment (pdq) -- health professional version. [7] - Tests to diagnose renal pelvis and ureter cancer, such as cytology, are done when symptoms or routine tests suggest a problem.

The differential diagnosis for renal pelvis adenocarcinoma can be quite challenging, but there are several key considerations to keep in mind.

Primary Differential Diagnoses

• Metastatic digestive-origin adenocarcinoma in the renal pelvis: This is a common consideration, especially if the patient has a history of gastrointestinal cancer. [1][2]
• Renal cell carcinoma (RCC): While RCC is typically a distinct entity from adenocarcinoma, there can be some overlap in presentation and histology. [3][4]

Other Differential Diagnoses

• Transitional cell carcinoma (TCC) of the renal pelvis: This is another type of cancer that can occur in the renal pelvis, although it tends to have a different histological appearance than adenocarcinoma.
• Urothelial carcinoma with extensive squamous differentiation: This is a rare variant of urothelial carcinoma that can mimic adenocarcinoma in some cases. [5]
• Clear cell RCC with secondary invasion into the renal pelvis: In some cases, clear cell RCC can invade the renal pelvis and be mistaken for adenocarcinoma.

Diagnostic Approaches

• Detailed histopathological and immunohistochemical analysis are essential to distinguish between these differential diagnoses.
• PET/CT scans may also be useful in evaluating the extent of disease and guiding further diagnostic workup. [6][7]

It's worth noting that the diagnosis of renal pelvis adenocarcinoma can be challenging, and a multidisciplinary approach involving urologists, pathologists, and radiologists is often necessary to arrive at an accurate diagnosis.

References:

[1] X Xiong et al. (2016) - Renal pelvic and ureter adenocarcinomas are often associated with chronic inflammation and subsequent chronic infection... [Context #1]

[2] W Gazzah et al. (2024) - In our case, the primary differential diagnosis was the possibility of metastatic digestive-origin adenocarcinoma in the renal pelvis... [Context #3]

[3] D Perez-Montiel et al. (2006) - In the renal pelvis, the main differential diagnosis is with secondary invasion by a clear cell renal cell carcinoma... [Context #9]

[4] M Dursun et al. (2021) - We suggested that PET/CT can be used for the differential diagnosis of renal pelvis tumor and RCC... [Context #6]

[5] The major differential diagnosis is urothelial carcinoma with extensive squamous differentiation... [Context #10]

[6] M Dursun et al. (2021) - We suggested that PET/CT may use the differential diagnosis of UTUCs... [Context #11]

[7] J Manski et al. (online textbook of urology) - Tumors of the renal pelvis: Papilloma of the urothelium; Urothelial carcinoma (synonym transitional cell carcinoma)... [Context #13]