Types of kidney tumors, their detection and treatment
Benign kidney tumor types differ from malignant neoplasms in that they do not germinate into nearby organs and tissues, do not cause metastases, and only rarely cause organ failure.
Usually benign tumors do not manifest themselves in any way and are diagnosed completely by accident, and also do not require urgent treatment.
Types of pathology
Depending on the nature of the supply of organs and parts of the body with blood vessels, tumors in the kidneys can be classified into the following types: avascular, hypovascular and hypervascular kidney tumors.
There are the following varieties of benign kidney tumors:
- Adenoma is the most common type of benign neoplasm. As a rule, such a tumor does not reach large sizes, it is characterized by a slow growth. The reasons for the development of adenoma in the kidney remain unclear, since the tumor does not cause any symptoms, and according to statistics, it occurs in 7 - 22% of cases. Occasionally, provided that the neoplasm reaches a large size, it begins to put a heavy pressure on the blood vessels and urinary canals - a symptom is formed resembling a kidney oncology. In a microscopic examination, adenoma in the kidney is similar to a low-grade form of renal cell carcinoma. Despite the fact that this species belongs to benign processes, at the moment there is no classification that would distinguish it from renal cell carcinoma.
- A renal oncocytoma is a benign neoplasm that does not cause any symptoms and can grow to large sizes. A similar tumor can affect other organs in the body. The reasons for the formation of such a tumor remain unknown. Oncocytoma is more often diagnosed in men and is recognized accidentally with ultrasound examination, computed tomography. Many experts refer the oncocyte to the precancerous stage and give recommendations to remove it surgically.
- Angiomyolipoma is a benign neoplasm of the kidney that occurs rarely and is triggered by genetic mutations. Such a disease can develop in isolation, but is mainly supplemented by a rare hereditary disease - tuberous sclerosis. In this case, this species is formed in the kidneys, on the skin, in the brain and in other organs. In 80% of cases of tuberous sclerosis, a kidney tumor is diagnosed. The treatment of angiomyolipoma is correlated with its size and the severity of the signs. If the size of the tumor is small and does not provoke symptoms, then treatment will not be required. In this case, patients will need to be observed by a specialist and periodically conduct an ultrasound examination. With a large tumor size, a surgical procedure is required because of the risk of spontaneous rupture.
- Fibroma in the kidney is a tumor from the fibrous tissue that forms on the surface of the kidney or inside it. This is a rare type of pathology, which mostly affects the female body. The reasons for the formation remain unknown, and the fibroma in the kidney does not manifest itself, is mainly located on the periphery and before the manifestation of clinical signs grows to large sizes.
- Lipoma in the kidney is a tumor formation from adipose tissue that is formed from cells that are part of the renal fat capsule or nearby tissues. Typically, this species develops in female representatives in middle age. Like other benign tumors, it can eventually become a malignant process, so doctors recommend surgical removal. Benign neoplasms in the kidneys most often occur asymptomatically and become an accidental diagnosis during an x-ray or ultrasound examination, surgery or autopsy.
In rare cases, when the tumor reaches a large size, non-specific signs begin to appear - pain in the lumbar region and on the sides of the abdomen, hematuria, renal colic, pathological components in the urine, increased blood pressure and palpable tumor.
Symptoms of hemorrhage and rupture include unexpected severe pain in the abdomen and from the sides, hematuria up to hemorrhagic shock. The apparent similarity of clinical signs hinders the classification of benign and malignant tumors.
An important role in the diagnostic process is played by ultrasound examination and CT.
Treatment of pathology
The therapeutic process in the development of a benign tumor in the kidney is still provoking a lot of disputes among specialists. According to the medical literature it becomes clear that for such tumors a slow increase in size is characteristic - up to about 5 mm in two to five years of patient observation.
Most physicians are of the opinion that for tumors up to 3 cm in size, periodic monitoring by a physician with a control examination organization is required every six to twelve months. In the case of rapid growth of neoplasm and changes in the results of ultrasound, surgical treatment of pathology is required. Adenomas of medium size - more than 3 cm - should be classified as potential malignant neoplasms. But in medicine, cases of metastasis of morphologically mature tumors with a diameter not exceeding 2 cm were recorded.
Unexpected hemorrhages in the tissue, accompanied by rupture of the capsule of the kidney and the formation of a hematoma in the area behind the peritoneum, usually occur when the growth of the tumor exceeds 3 cm in diameter. In this regard, the large size of tumor formation is considered an indication for the organization of a kidney resection. Do not forget about the possibility of malignization of the tumor or the development of carcinoma against the background of the tumor.
In the process of making a decision on the necessity of carrying out and the volume of the operation, the doctor takes as a basis the data of the urgent histological examination. With morphologically confirmed benign nature of the process, it is possible to perform organ-preserving surgical manipulations, such as resection of the kidney within the tissues unaffected by pathology. The detection of signs of malignancy of the process becomes an indisputable indication for the realization of nephrectomy and subsequent combined treatment.
The prognosis for the development of benign neoplasm of the kidney as a whole remains favorable and noticeably better compared with kidney cancer. But after completion of the treatment, the doctor is obliged to conduct control studies of the affected organ due to the high risk of recurrence of the disease, accompanied by the occurrence of metastases.