Kidney cancer (renal cell carcinoma, Wilms tumor and other types)

Types and characteristics

Major types include:

• Renal cell carcinoma (RCC) — arises from the kidney’s tubular cells and has several subtypes with different microscopic features. See renal cell carcinoma.
• Urothelial (transitional cell) carcinoma — originates in the lining of the renal pelvis and resembles bladder cancers.
• Wilms tumor — a childhood kidney cancer with distinct clinical behavior and treatment, discussed separately at Wilms tumor.
• Other rare types include sarcomas and lymphomas involving the kidney.

Causes and risk factors

The exact cause of most kidney cancers is not known, but several factors increase risk: cigarette smoking, excess body weight, long-standing high blood pressure, certain inherited syndromes (for example von Hippel–Lindau, Birt–Hogg–Dubé, tuberous sclerosis), and some occupational exposures. Family history can be relevant in hereditary forms.

Symptoms and diagnosis

Symptoms may include blood in the urine (hematuria), persistent flank pain, a palpable mass, unexplained weight loss, fever, or fatigue. Many cases are detected incidentally on imaging studies done for other reasons. Diagnostic evaluation typically uses ultrasound, contrast-enhanced CT or MRI, and sometimes biopsy to confirm the diagnosis and guide management.

Treatment and prognosis

Treatment depends on stage, tumor type, and patient factors. Localized tumors are often managed surgically by partial or radical nephrectomy, with an emphasis on preserving kidney function when possible. Advanced or metastatic disease may be treated with targeted therapies, immunotherapy, or a combination, and radiation is used selectively. Prognosis varies widely: early-stage disease has a better outlook, while advanced spread reduces long-term survival.

Importance and notable facts

Kidney cancers are distinct in their biology and response to systemic agents compared with many other solid tumors. Incidental detection has increased with the common use of abdominal imaging, leading to earlier diagnosis in many cases. Prevention focuses on reducing modifiable risks—quitting smoking, maintaining healthy weight and blood pressure—and awareness of hereditary syndromes when family history suggests increased risk.