Dissemination and metastasis of renal cancer

The metastasis of kidney cancer varies greatly. Some tumors are very large but have no metastasis, while some tumors are very small but have distant metastasis. There are three ways of metastasis.

1. Direct dissemination

Direct spread can pass through the renal capsule to the surrounding tissues or invade the renal vein and inferior vena cava. If the renal pelvis is invaded, hematuria may occur clinically. At the same time, renal cancer can also invade the surrounding tissues such as the colon, pancreas, adrenal glands, peritoneum, liver, spleen, etc.

(II) Lymphatic metastasis

15%-30% of kidney cancer metastasizes through the lymphatic pathway. On the left side, it metastasizes to the renal pedicle, the preaortic and left lymph nodes, and on the lateral side, it involves the renal hilum, the pre-inferior vena cava lymph nodes, and the lymph nodes between the aorta and the inferior vena artery. It can metastasize upward to the neck and cause cervical lymph node enlargement, etc.

(III) Hematogenous metastasis

Cancer invades the renal vein, causing cancer thrombus formation in the vein, which can metastasize to the lungs, liver, bones, etc. At the same time, the cancer thrombus can extend from the renal vein to the internal spermatic vein (plexus), or the ovary and internal vaginal veins, causing metastasis to the spermatic cord, epididymis, broad ligament of the uterus, vagina, labia, etc. The incidence of cancer cells metastasizing to the renal vein and inferior vena cava is 20% and 10% respectively.