Renal Cell Carcinoma - Signs and Symptoms

Signs and Symptoms

A wide range of symptoms can be present with renal carcinoma depending on which areas of the body have been affected. The classic triad is hematuria (blood in the urine), flank pain and an abdominal mass. This triad only occurs in 10-15% of cases, and is generally indicative of more advanced disease. Today, the majority of renal tumors are asymptomatic and are detected incidentally on imaging, usually for an unrelated cause.

Signs may include:

• abnormal urine color (dark, rusty, or brown) due to blood in the urine (found in 60% of cases)
• loin pain (found in 40% of cases)
• abdominal mass (25% of cases)
• malaise, weight loss or anorexia (30% of cases)
• polycythemia (5% of cases)
• anemia resulting from depression of erythropoietin (30% of cases) Also, there may be erythrocytosis (increased production of red blood cells) due to increased erythropoietin secretion.
• the presenting symptom may be due to metastatic disease, such as a pathologic fracture of the hip due to a metastasis to the bone
• varicocele, the enlargement of one testicle, usually on the left (2% of cases). This is due to blockage of the left testicular vein by tumor invasion of the left renal vein; this typically does not occur on the right as the right gonadal vein drains directly into the inferior vena cava.
• vision abnormalities
• pallor or plethora
• hirsutism - excessive hair growth (females)
• constipation
• hypertension (high blood pressure) resulting from secretion of renin by the tumour (30% of cases)
• elevated calcium levels (hypercalcemia)
• Stauffer syndrome - paraneoplastic, non-metastatic liver disease
• night sweats
• severe weight loss

Patients may also experience the following symptoms:

• recurrent fevers which occur in 9% of the patients
• cold intolerance
• back pain
• chronic fatigue
• leg and ankle swelling
• loss of appetite