INCIDENCE AND DIAGNOSIS

Renal cell carcinoma (RCC) is the most common malignancy of the kidney. In 2007, there were more than 51,100 new cases of RCC in the United States, and 12,890 patients died from the disease (1). The incidence of RCC has been on the rise since the latter part of the twentieth century, independent of advances in abdominal imaging that have improved diagnostic potential (2). According to the National Cancer Institute's 1975 to 1995 Surveillance, Epidemiology, and End Results database, this increase has been seen in both women and men and across racial boundaries (3).

RCC is associated with older age and is increasingly diagnosed in patients past the fifth decade of life. In addition to age, the only risk factors for RCC are smoking and tobacco exposure. Other factors that may be associated with a high risk of RCC include obesity, diabetes mellitus, hypertension, diuretic use, high alcohol intake, high fat intake and high red meat intake; however, the causative potential of these factors is yet unproven (4).

The kidney is a well-protected, markedly silent organ. It is sheltered within the rib cage and is often surrounded by a thick rind of fat, and it is innervated to respond to only acute visceral distension. Thus, small renal tumors typically develop asymptomatically. The classic symptoms of RCC are abdominal mass, pain and hematuria. This presentation is rare, but when these symptoms do occur, they are a signal for advanced-stage disease.