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Fuhrman grade : ウィキペディア英語版
Renal cell carcinoma

Renal cell carcinoma (RCC, also known as hypernephroma, Grawitz tumor, renal adenocarcinoma) is a kidney cancer that originates in the lining of the proximal convoluted tubule, a part of the very small tubes in the kidney that transport waste molecules from the blood to the urine. RCC is the most common type of kidney cancer in adults, responsible for approximately 90-95% of cases.
Initial treatment is most commonly either partial or complete removal of the affected kidney(s) and remains the mainstay of curative treatment. Where the cancer has not metastasised (spread to other organs) or burrowed deeper into the tissues of the kidney, the 5-year survival rate is 65-90%,〔http://www.nhs.uk/conditions/Cancer-of-the-kidney/Pages/Introduction.aspx〕 but this is lowered considerably when the cancer has spread. It is relatively resistant to radiation therapy and chemotherapy, although some cases respond to targeted therapies such as sunitinib, temsirolimus, bevacizumab, interferon alfa and sorafenib which have improved the outlook for RCC.
The body is remarkably good at hiding the symptoms and as a result people with RCC often have advanced disease by the time it is discovered. The initial symptoms of RCC often include: blood in the urine (occurring in 40% of affected persons at the time they first seek medical attention), flank pain (40%), a mass in the abdomen or flank (25%), weight loss (33%), fever (20%), high blood pressure (20%), night sweats and generally feeling unwell.〔
RCC is also associated with a number of paraneoplastic syndromes (PNS) which are conditions caused by either the hormones produced by the tumour or by the body's attack on the tumour and are present in about 20% of those with RCC.〔 These syndromes most commonly affect tissues which have not been invaded by the cancer.〔
The most common PNSs seen in people with RCC are: high blood calcium levels, polycythaemia (the opposite to anaemia, due to an overproduction of erythropoietin), thrombocytosis (too many platelets in the blood, leading to an increased tendency for blood clots and bleeds) and secondary amyloidosis.〔
When RCC metastasises, it most commonly spreads to the lymph nodes, lungs, liver, adrenal glands, brain or bones.〔
== Signs and symptoms ==
Historically, medical practitioners expected a person to present with three findings. This classic triad〔 is 1: haematuria, which is when there is blood present in the urine, 2: flank pain, which is pain on the side of the body between the hip and ribs, and 3: an abdominal mass, similar to bloating but larger. It is now known that this classic triad of symptoms only occurs in 10-15% of cases, and is usually indicative that the renal cell carcinoma (RCC) in an advanced stage.〔 Today, RCC is often asymptomatic (meaning little to no symptoms) and is generally detected incidentally when a person is being examined for other ailments.〔
Other signs and symptom may include haematuria;〔 loin pain;〔 abdominal mass;〔 malaise, which is a general feeling of feeling unwell;〔 weight loss and/or loss of appetite;〔 anaemia resulting from depression of erythropoietin;〔 erythrocytosis (increased production of red blood cells) due to increased erythropoietin secretion;〔 varicocele, which is seen in males as an enlargement of the tissue at the testicle (more often the left testicle)〔 hypertension (high blood pressure) resulting from secretion of renin by the tumour;〔 hypercalcemia, which is elevation of calcium levels in the blood;〔 sleep disturbance or night sweats;〔 recurrent fevers;〔 and chronic fatigue.〔

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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