What are the main clinical manifestations of renal cell carcinoma?

Renal tumors can have typical manifestations such as hematuria, backache and waist lump. But this progress shows that the tumor has reached an advanced stage. Clinically, the occurrence of triad is rare, accounting for about 10% ~ 15% of the total.

1. Hematuria is the most common symptom, and about 60% patients have hematuria. It can be gross hematuria and/or microscopic hematuria. Most of them are painless hematuria, and sometimes there is blood in the urine. In most cases, hematuria is caused by tumor invading renal pelvis and calyx. Hematuria is almost the only symptom in patients with renal pelvis cancer.

2. The occurrence of low back pain is because the renal capsule is tense and enlarged after the tumor grows up, or it invades the surrounding tissues. It is characterized by persistent dull pain, which can cause severe persistent pain when the tumor has invaded the nerve or lumbar spine. The blood in hematuria condenses into a cord-like blood clot in the ureter, which can cause renal colic when discharged with urine.

3. 10% of patients with lumbar masses can touch the masses in the waist or upper abdomen. Sometimes it may be the only symptom. The mass is hard in texture and uneven or nodular in surface. If the patient is emaciated or the mass is located in the lower pole of the kidney, the mass can be palpated during physical examination. If the mass is fixed, it means that there is infiltration around the kidney and the prognosis is not good.

4. varicocele When the left renal parenchymal tumor compresses the left spermatic vein, varicocele often appears on the left side. Varicocele does not disappear after lying down because of tumor thrombus or other obstruction in vein. When the inferior vena cava is invaded, edema of lower limbs can occur at the same time.

Second, the symptoms of systemic poisoning

Fever, anemia, emaciation and anorexia are common manifestations of malignant tumors. Because of the high degree of malignancy of renal cell carcinoma, many patients have obvious systemic symptoms during treatment, even lung and bone metastasis.

Fever is one of the most common systemic manifestations of renal cell carcinoma. Low fever and high fever may occur, and those with persistent high fever may pass 39 ~ 40℃. Most scholars believe that fever is related to the heat source of cancer tissue. The body temperature returned to normal after tumor resection. Fever is the only manifestation of renal cell carcinoma in a few patients (2% ~ 3%). Some middle-aged and elderly patients with fever of unknown origin should be alert to the existence of renal cell carcinoma.

Urine blood in patients with renal cell carcinoma can cause anemia, but most patients with renal cell carcinoma suffer from insufficient blood loss. Therefore, anemia in patients with renal cancer is mainly due to tumor growth and tumor toxin, and the destruction of a large number of renal tissues inhibits most of the hematopoietic function of bone marrow. Some patients have leukemia-like manifestations, and the white blood cells in the blood can be as high as several times to dozens of times the normal value.

Patients with renal cell carcinoma can also have abnormal liver function and hepatosplenomegaly, leading to abdominal distension, pain, tiredness, ascites, anorexia, fatigue and other symptoms.

Dysfunction of endocrine organs

Kidney plays a very important role in human endocrine system. Can secrete a variety of endocrine hormones. Therefore, there are many endocrine abnormalities in the kidney, including erythropoietin, renin, parathyroid hormone and glucagon. A few renal cell carcinomas are also complicated with gonadotropin elevation. The clinical manifestations are erythrocytosis, renal hypertension, hypercalcemia, gastrointestinal motility and abnormal absorption.

According to statistics, only 40% of patients with renal cell carcinoma have urinary system symptoms, and 20% have no obvious clinical symptoms. The remaining 40% have only general symptoms, such as fatigue, listlessness, loss of appetite, nausea and indigestion.

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