What Is a Renal Pelvic Tumor?

Most of the renal pelvis tumors are transitional cell papillary tumors. Squamous cell carcinoma of the renal pelvis is rare, and most are associated with long-term urinary stones and infections. Early manifestations are intermittent painless gross hematuria, often without tumors and pain, and renal angina occasionally due to clots blocking the ureter. Urine tests can find cancer cells, X-rays show filling defects and deformation of the renal pelvis, and cystoscopy shows bleeding urine at the ureter. The diseased kidney and ureter, including the bladder wall at the opening of the ureter, should be surgically removed.

Most of the renal pelvis tumors are transitional cell papillary tumors. Squamous cell carcinoma of the renal pelvis is rare, and most are associated with long-term urinary stones and infections. Early manifestations are intermittent painless gross hematuria, often without tumors and pain, and renal angina occasionally due to clots blocking the ureter. Urine tests can find cancer cells, X-rays show filling defects and deformation of the renal pelvis, and cystoscopy shows bleeding urine at the ureter. The diseased kidney and ureter, including the bladder wall at the opening of the ureter, should be surgically removed.

Chinese name

Pelvic tumor

Foreign name

tumoroftherenalpelvis

Causes of pelvic tumors and common diseases

Tumors of the renal pelvis are common in transitional cell carcinoma, accounting for about 10% of renal tumors, and can be accompanied by ureteral, bladder, or contralateral renal pelvis tumors simultaneously or successively. Occurs between the ages of 40 and 70, with a male to female ratio of 2: 1. Can be single or multiple shots. The degree of tumor differentiation and infiltration varies widely. Metastatic pathways often have early lymphatic metastases. Squamous cell carcinoma of the renal pelvis is rare and is mostly associated with long-term urinary stones and infections. Early manifestations are intermittent painless gross hematuria, often without tumors or pain, and renal colic occasionally due to clogging of the ureter. Symptoms such as anemia and weight loss may appear in the late stage.

Differential diagnosis of pelvic tumor

(A) Early manifestations: intermittent painless gross hematuria, often without pain and lumps, and occasionally colic caused by clots blocking the ureter.

(B) urine cytology examination: easy to find cancer cells.

(C) cystoscopy: bleeding urine can be seen at the ureter.

(D) urography: filling defect and deformation in the renal pelvis. Should be distinguished from uric acid stones or blood clots.

(5) Ureteral nephroscopy, B-ultrasound, and CT examinations are of great value in the diagnosis of renal pelvic cancer.

Pyelone tumor examination

(A) physical examination

Most patients have no positive signs. There may be tenderness or throbbing of the rib spine. About 7% of advanced patients have cachexia.

(Two) auxiliary inspection

1. Urine routinely sees red blood cells.

2. Urinary cytology positive rate of poorly differentiated cancer can reach about 60%, fresh urine can be left in the morning after centrifugation, and the sediment is examined by microscopy.

3. Intravenous urography shows renal pelvis filling defect, which may be accompanied by hydronephrosis.

4. Retrograde pyelography is more clear, blood may be seen from the ureteral orifice of the affected side, and pelvic urine can be taken or the pelvis can be collected for cytological examination.

5. Ureteroscopy can carefully and intuitively examine the renal pelvis, especially the tumors in the calamity.

6. Ultrasonography can detect tumors in the renal pelvis, which are manifested as renal parenchymal echo separation, with abnormal hypoechoic areas inside, with obvious three-dimensional sense, which can show the tumor surface morphology. Tumor obstruction can cause hydronephrosis in the pelvis and ureter.

7. CT can distinguish between renal pelvis cancer and renal cancer, showing a solid mass in the renal pelvis, renal calamity can expand spherically, and the enhancement is not obvious after injection of contrast agent.

8. MRI can distinguish between renal pelvis cancer and renal cancer, which is more meaningful for finding whether the tumor invades surrounding tissues, organs and lymph nodes and staging the tumor.

9. Renal arteriography can find tumor blood vessel changes, arterial branches are missing, tumor blood vessels are small, and the renal parenchymal phase exhibits an irregular decrease in density when the renal parenchyma is invaded.

Renal Pelvic Tumor Treatment Principles

(1) Surgical treatment: The kidney, full-length ureter, pararenal tissue, and lymph nodes are removed as a whole. A part of the bladder around the ureteral orifice should also be removed.

(2) Radiation therapy: can be used as adjuvant treatment before or after surgery or as a treatment to reduce symptoms. Post-operative and radiotherapy are suitable for cases with incomplete surgical resection and residual tumor.