BENIGN TUMORS

Renal papillary adenoma Renal fibroma or hamartoma Angiomyolipoma Oncocytoma

–Small tumors measuring 0.5 mm in
diameter
–Tumors greater than 3.0 cm in
diameter are considered early cancers
–Completely benign –Present in patients with tuberous –May be large up to 12.0 cm
sclerosis (25-50%)
–Less than 1.0 cm –EM findings reveal eosinophilic
epithelial cells packed within the
–Found in the medulla mitochondria

–Almost never metastasizes

Wilms tumor
•Most common tumor in patients with ages 2-5
yrs old
•Good survival rate (90%)
•Malformation syndromes occur with
chromosome 11p
Types:
1. WAGR (Wilms tumor, aniridia, genital
anomalies, mental retardation)
–a. involves deletion of chromosome 11p band
13
2. Denys Drash syndrome
–Genetic abnormality is the dominant negative
mutation in the WT-1 gene
–patients present with gonadal dysgenesis,
nephropathy and renal failure
3. Beckwith-Wiedemann syndrome
–involves deletion of chromosome 11 band
p15.5 (WT-2 gene)
–characterized histologically by blastema,
immature stroma and tubules
–may be associated with anaplasia (5%)
MALIGNANT TUMORS
Renal Cell Carcinoma Transitional Cell Carcinoma
•Also known as Hypernephroma •2% of all malignant tumors
•80 to 90% of malignant tumor of the kidney •Predominantly found in patients between the ages to 50
•1 to 3% of all cancers to 80
•Predominantly occurs on the 6 to 7 decade of life •Chromosome 9 and 17p deletion are implicated
•Presents as painless hematuria (90%) •Most important evaluation tool for prognostication is
Risk factors: depth of invasion
–Cigarette smoking
–Obesity Otherwise known as urothelial tumors
–Hypertension •95% of all bladder tumors
–Unopposed estrogen therapy
–Exposure to heavy metals Epidemiology:
–80% of patients are between 50-80 yrs ol
Appears as yellowish spherical masses (3-15 cm diameter) –cigarette smoking
•von Hippel-Lindau (VHL) syndrome 50-70% develop RCC –schistosoma haematobium infections
•inherited as autosomal dominant trait –cyclophosphamide
–industrial exposure to arylamines (2-napthylamine)
Major classification types:
•Clear cell (70-80%) Prognosis
•Papillary carcinoma (10-15%) Grade Prognosis (10 yr survival)
•Chromophobe renal carcinoma (5%) Grade 1(papilloma) 98%
Prognosis Grade 3 65%
–45% five year survival rate
–70% in the absence of metastasis