Malignant tumor on the kidney, you need to know these

The kidneys play an extremely important role in the human body. Malignant tumors on the kidneys will make patients anxious, worrying whether their lives will be directly endangered. Indeed, this is a very serious disease that occurs more frequently in middle-aged men. Its most common symptoms are blood in the urine, abdominal lumps, and back pain. As the disease worsens, more serious symptoms will appear, so it is very important to seek medical treatment in a timely manner. The best treatment for this disease is surgery, which of course also requires preoperative embolization and interventional treatment. For the sake of their own health, patients need to undergo surgery in a timely manner.

1. Overview of the disease

Kidney, commonly known as kidney, accounts for about 80% to 90% of malignant kidney tumors and is more common in men over 40 years old. Kidney cancer can develop anywhere in the kidney. The tumor gradually grows and may invade the renal pelvis, calyces, and ureters. It can also invade the renal vein, forming cancer thrombi in the renal vein, inferior vena cava, and even right atrium, and can spread to the tissues around the kidney and form distant metastases through the blood and lymph.

2. Diagnostic points

Kidney cancer is often asymptomatic in its early stages. Its three typical manifestations are hematuria (blood in the urine), abdominal masses, and back pain. Hematuria indicates that the tumor has invaded the blood vessels or renal pelvis and calyces, marking the progressive stage of the disease. Kidney cancer can produce a variety of hormones and hormone-like substances that cause various symptoms, including ① erythropoietin can cause polycythemia; ② parathyroid hormone causes hypercalcemia; ③ renin can cause hypertension; ④ adrenal glucocorticoids can cause Cushing syndrome.

The diagnosis of renal cancer mainly relies on clinical manifestations and related examinations. When all three typical symptoms appear, it is already in the late stage. Plain X-rays have little diagnostic value; after the tumor invades the renal calyx and renal pelvis, intravenous pyelography can show changes such as deformation, dilation and hydrops caused by compression and erosion of the renal calyx and renal pelvis. Two-dimensional ultrasound has now become a commonly used examination method for diagnosing renal cancer. The accuracy of ultrasound in differentiating renal cysts from renal solid masses can reach 90% to 95%. CT is an indispensable means of diagnosing renal cancer. It can show the size, location, range of invasion, presence of lymph node enlargement, intravenous cancer thrombus and metastasis to adjacent organs. An important role of MRI in the diagnosis and proper staging of renal cancer is the visualization of tumor thrombi in the renal vein and inferior vena cava. MRI is also very helpful in understanding the relationship between kidney cancer and surrounding organs and structures. It can be used to observe from different planes whether kidney cancer has invaded surrounding organs and structures. Renal arteriography is an important method for diagnosing renal tumor diseases and has become an important part of interventional radiological diagnosis and treatment. Abdominal aortography and selective renal arteriography can provide data for selecting treatment options and provide guidance for interventional treatment.

3. Treatment options

Radical surgical resection is the preferred treatment for renal cancer. Other options include interventional therapy, hormone therapy, chemotherapy, and immunotherapy. Interventional treatment of renal cancer is used for 1. Preoperative embolization: The advantages of renal artery embolization before surgery are mainly to reduce intraoperative bleeding and reduce the possibility of tumor metastasis through the vein. 24 to 72 hours after renal artery embolization, the embolized tumor and kidney will swell, and the kidney interface will be clearly displayed, which is conducive to the detachment and complete removal of the tumor. 2. Simple interventional treatment is a palliative treatment for patients with advanced renal cancer who have no surgical indications or are unwilling to undergo surgery. The goal is to cause tumor infarction, control or alleviate the serious symptoms caused by the tumor, shrink the tumor, stabilize and improve the overall condition, and slow down the growth rate of the tumor.

Femoral artery puncture is usually used for abdominal aortography or selective renal artery angiography. After observing the angiographic findings, selective and superselective infusion of chemotherapy drugs and embolization are performed on tumor-related blood vessels. Embolism can be classified as permanent or temporary, complete or incomplete. Commonly used embolic agents include: anhydrous alcohol, gelatin sponge, Chinese medicine Bletilla striata powder, steel ring and iodized oil + anticancer drugs, etc.

4. Complications and treatment

1. Post-embolization syndrome: including embolization side low back pain, low fever, nausea and vomiting, which are generally mild and can be recovered in a short time with symptomatic treatment. 2. Ectopic embolism: Due to poor visibility of the embolic material under X-rays or the presence of collateral vessels, the embolic material enters other parts and forms an ectopic embolism. For milder ectopic embolism, there are generally no serious consequences after symptomatic treatment. In very rare cases, embolism of the spinal cord blood supply artery may cause serious consequences such as lower limb paralysis and incontinence. For patients with large arteriovenous fistulas, pulmonary embolism may occur.

5. Health care and rehabilitation treatment

Palliative treatment means that the tumor cannot be cured and further chemotherapy or other treatments are required. After one renal artery is embolized, you should pay attention to protecting the function of the other kidney, drink plenty of water, and avoid taking drugs that affect renal function.