Renal Pelvis Tumors Health Article

Definition

Renal pelvis tumors are rare kidney cancers appearing in a specific part of the kidney known as the pelvis of the kidney.

Description

The word renal means having to do with the kidneys. A part of each kidney in the human body is called the renal pelvis. The renal pelvis in each kidney is the portion of the collecting system of the kidney that empties into the ureters (tubes that carry urine from the kidneys to the bladder). Tumors of the renal pelvis are rare.

Renal pelvis tumors usually appear after an earlier condition, called renal papillary necrosis, has already developed. The tumors can be composed of any one of several different types of cells. Most commonly, these tumors are of a type of cell known as a transitional cell carcinoma.

A transitional cell is intermediate between the flat squamous cell and the tall columnar cell. It is restricted to the epithelium (cellular lining) of the urinary bladder, ureters, and the renal pelvis. Transitional cell carcinomas have a wide range in their gross appearance depending on their locations. Some of these carcinomas are flat in appearance, some are papillary (small elevation), and others are in the shape of a node. Under the microscope, however, most of these carcinomas have a papillary-like look. There are three generally recognized grades of transitional cell carcinoma. The grade of the carcinoma is determined by particular characteristics found in the cells of the tumor. Transitional cell carcinoma typically affects the mucosa (the moist tissue layer that lines hollow organs or the cavity of the body) in the areas where it originates— in this case, the kidney.

Demographics

Because statistics on these tumors are gathered with statistics on other kidney tumors, little information specific to tumors of the pelvic area of the kidney, as opposed to other areas of the kidney, is available. It seems probable, however, that these tumors appear most commonly in persons between the ages of 50 and 70.

Causes and symptoms

The appearance of renal pelvis tumors is associated with a history of cigarette smoking and the overuse of certain pain medicines, as well as with a history of either urinary tract inflammation kidney stones, or bladder cancer. People who have worked in the rubber, paint, dye, printing, textile, and plastic industries and been exposed to certain chemicals are also at increased risk for this type of cancer. The risk is elevated, as well, for people with a rare kidney condition called Balkan nephropathy. This condition is more likely to affect people from Romania, Greece, Bulgaria, Serbia, Croatia, Bosnia-Herzegovina, and other countries that formerly comprised Yugoslavia.

Approximately four out of five patients have symptoms of blood in the urine at the time of diagnosis. Approximately one out of three patients experiences pain in the side. Other patients may have no symptoms, while others may feel generally ill, visit the doctor for this general complaint, and have the cancer diagnosed at that time.

Diagnosis

Either urography or pyelography may be used to diagnose renal pelvis tumors. Both urography and pyelography are types of x-ray procedures that may be used to visualize portions of the urinary tract. The kidneys are part of the urinary tract. If urography is used, it is usually followed by cystoscopy. Cystoscopy involves the use of a medical instrument that permits the physician to look directly at portions of the urinary tract.

A newer technique is called ureteroscopy. Performing ureteroscopy increases the diagnostic accuracy doctors are able to attain. However, there is a risk that ureteroscopy may cause damage to some portion of the urinary tract. Therefore, ureteroscopy is usually reserved for those patients for whom unanswered questions remain after conventional diagnostic approaches have been completed.

The doctor may also order an x ray of the chest, a bone scan, and liver function tests to see whether the cancer has spread.