Tumor development on the kidney is usually seen after the age of 40. The exact cause is unknown. The risk of being seen is higher in smokers, those who are exposed to certain chemicals for a long time (such as asbestos, cadmium), obese, those who have hemodialysis due to chronic kidney failure, those with high blood pressure, and some genetic diseases (such as VHL disease).
Kidney Tumor Symptoms, Findings and Diagnosis
Today, most kidney tumors are detected incidentally while they are small in size without causing any clinical symptoms. This is because abdominal ultrasonography or tomography is widely used. Those who grow up to give symptoms can cause flank pain, bleeding in the urine, and high blood pressure, anemia, weight loss, deterioration of liver functions caused by some substances released from the tumor tissue in the kidney.
If there is suspicion about the mass lesion in the kidney such as spreading from elsewhere, or if the patient is unable to be operated, or if non-surgical treatment methods such as burning-freezing (radiofrequency-cryoablation) are planned, a differential diagnosis can be made by taking biopsy. Otherwise, direct surgical treatment is started without biopsy.
Kidney Tumor Treatment
In tumors that are not large (usually 7 cm and below), the tumor can be removed without the need to remove the entire kidney (partial-partial nephrectomy). In large masses or in cases where it is not possible to save the kidney, the entire kidney and surrounding adipose tissue is removed (Radical nephrectomy). These surgeries can be performed open, laparoscopically or robot-assisted laparoscopically.
It is known that removal of tumoral masses in the kidney, where possible, is beneficial in terms of survival, even if there are signs of spreading to other parts of the body.
In cases where the tumor is limited to the kidney tissue, surgical treatment is sufficient and no additional treatment is given afterwards. When there is regional lymph node involvement or distant organ spread, immunomodulating drugs (Interleukin 2, Interferon alfa) are given first. In the second step, drugs (tyrosine kinase inhibitors, antiangiogenetics) are used to reduce the vascular structure and blood supply of the kidney tumor and to feed it. Chemotherapy may be useful in some specific types of kidney tumors.