What Is a Kidney Mass?

Renal benign tumors are a collective term for most renal benign tumor diseases.

Benign tumor of kidney

Renal benign tumor disease

Renal benign tumors are a collective term for most renal benign tumor diseases.

Renal benign tumors

1. Obesity and hypertension: A prospective study published in the New England Journal of Medicine published on November 2, 2000 shows that high body mass index (BMI) and hypertension are associated with an increased risk of kidney tumors in men Two independent factors.

2. Genetics: There are some kidney tumors in the family that are found during chromosome examination. A third pair of chromosomes is defective in people with a high incidence of kidney tumors. Most familial renal tumors have an earlier age of onset and tend to be multifocal and bilateral. A rare hereditary disease, hereditary canthariform hamartoma (VHP) disease, occurs in as many as 28% to 45% of patients with kidney tumors.

3. Smoking: A large number of prospective observations have found that smoking is positively correlated with kidney tumors. Relative risk factor (RR) for kidney tumors in smokers = 2, and people who have smoked for more than 30 years and smoked filterless cigarettes have an increased risk of kidney tumors.

4. Food and Drugs: The investigation found that high intake of dairy products, animal protein and fat, and low intake of fruits and vegetables are risk factors for kidney tumors. Coffee may increase the risk of kidney tumors regardless of coffee consumption. In animal experiments, kidney tumors due to female hormones (estrogen) have been proven, but there is no direct evidence in humans. Misuse of antipyretic and analgesics, especially phenacetin, can increase the risk of kidney cancer. Diuretics may also be factors that promote the development of kidney tumors. It was concluded through animal experiments that red rattan grass, also known as "thousand roots", may induce kidney tumors. The Korean Food and Drug Safety Agency has asked domestic companies to stop producing red rattan grass food additives.

5. Occupation: There is an increased risk of kidney tumor incidence and death among workers exposed to metal shops, newspaper printers, coke workers, dry cleaners and petrochemical workers.

6. Radiation: According to statistics, 26 of the 124 tumors caused by the use of a weak alpha particle radiation source were confined to the kidney. However, no reports of radiation exposure and kidney tumors by radiation workers and victims of the atomic bombing have been found.

7. Other diseases: In patients undergoing long-term maintenance hemodialysis, cystic changes (acquired cystic diseases) occur in atrophic kidneys, and there is an increase in cases of renal tumors. Therefore, those who have been on dialysis for more than 3 years should have an annual B-ultrasound to check their kidneys. It has been reported that people with diabetes are more likely to develop kidney tumors. 14% of patients with kidney tumors have diabetes, which is five times the normal population.

Renal benign tumor clinical diagnosis

I. Clinical manifestations

(A) Symptoms: Most are asymptomatic, and a small number of patients can cause gross hematuria and abdominal pain due to bleeding or rupture in the tumor.

(B) Physical examination: Occasionally touched a mass in the kidney area.

Inspection

(1) Routine urine tests are usually within the normal range.

(2) Determination of renal function, determination of creatinine and urea nitrogen.

(3) X-ray plain film of urinary tract, intravenous urography, to understand the relationship between tumor and renal pelvis and calamity, showing the location and size of the tumor, as well as bilateral renal function and morphology

(4) Retrograde pyelography. When venous urography shows dissatisfaction, retrograde urography can be used.

(E) B-ultrasound, CT, and MRI examinations are of great significance in determining benign and malignant tumors of the kidney.

Renal benign tumor clinical symptoms

Renal benign tumors are often asymptomatic in clinical practice, and most of them are accidentally found during pyelography or ultrasound. Renal benign tumors include the following:

1. Renal hamartoma

Occurs in young and middle-aged, more women than men. Tumors have a tendency to bleed, and sometimes they are huge. Smaller tumors are often clinically asymptomatic, and larger tumors can cause hematuria, low back pain, masses in the kidney area, and can cause upper urinary tract obstruction, and sometimes can induce hypertension. Diagnosis is mainly based on pyelography anti-ultrasonography, and CT scans are performed when difficult. CT examination can show that there is a fat density component in the tumor.

Renal fibroma

Because it is often located on the outer part of the kidney, it is already huge when found. Renal lipomas are rare, and so far only 18 cases have been reported in the literature. Most of the patients were middle-aged women and were already huge when they were discovered. The main symptoms are low back pain, some patients have hematuria, and CT examination shows typical fat density. Because kidney tissue is composed of many different types of cells, a variety of benign tumors can occur. Other rare tumors include fibroids, hemangiomas, and lymphangiomas.

3. Renal adenoma

Renal adenomas are more common in patients over 40 years of age, and most are asymptomatic. They are usually found during autopsy and are located in the renal cortex. Renal adenomas are occasionally found clinically on X-ray or ultrasound. It is difficult to distinguish from small-sized renal cancer in CT or angiography, but the adenoma has no arteriovenous fistula and no calcification of the venous blood pool. Adenomas below 3 cm are generally benign. Tumor cells can secrete renin, so it is also called reninoma.

Essentials of Renal Benign Tumor Treatment

1. Hamartomas smaller than 4cm can be left untreated.

Larger hamartomas are feasible for enucleation or partial nephrectomy. For larger tumors, damaged kidney structures, and loss of function, nephrectomy can be considered.

2. All types of renal malignant tumors should undergo radical nephrectomy early after diagnosis.

Various types of renal malignancies include adipose tissue around the kidney, para-aortic lymph nodes, most of the ureter and surrounding tissues, and the affected adrenal glands; if the renal vein tumor plug has extended to the vena cava, it should be removed and repaired Vena cava.

3. Radiation therapy

Patients with oversized tumors of nephroblastoma can undergo radiation therapy before surgery, and then undergo radical nephrectomy after the tumors have shrunk. Radiotherapy is less effective for renal pelvis and renal cell carcinoma.

4. Chemotherapy

Chemotherapy should be applied routinely to nephroblastoma, and can be applied to renal pelvis and renal cell carcinoma as appropriate. Mitomycin and fluorouracil can be used. Patients with renal cancer can choose as appropriate. Biological treatments such as interferon gamma, interleukin 2 and so on.

5, suffering from renal artery embolism

When the diagnosis of renal tumors requires resection, renal arterial embolization can be performed at the same time as selective renal angiography to reduce intraoperative bleeding and tumor cell metastasis.

6. Palliative renal artery embolism, supplemented by radiotherapy and chemotherapy

When the tumor involves a wide range and adjacent organs have been affected and cannot be removed, palliative renal artery embolization can be performed, supplemented with radiotherapy and chemotherapy.

7, chest radiography, B ultrasound and whole body bone scan (SPECT) follow-up examination

Renal tumor surgery requires regular follow-up examinations (three to six months) of chest radiography, B-ultrasound, and whole body bone scan (SPECT) to detect recurrence and metastasis of the renal pedicle.

[Follow-up]

Follow up every 3 to 6 months, paying special attention to abdominal and lung metastases

8. Radical nephrectomy

In addition to radical nephrectomy, all ureters and the bladder wall around the ureteral orifice should be removed at the same time.

Partial nephrectomy with isolated kidney technique

Partial nephrectomy can be performed with isolated kidney technique in patients with bilateral or isolated kidney and renal cancer.