Dull back pain unexpectedly kidney cancer

ung thư thận - Ảnh 1. — Laparoscopic removal of cancerous kidney cyst for patient D. - Photo: H.TUONG

Simple renal cysts account for 40-50% of incidental ultrasound findings in the elderly. Cysts are mostly benign, but if the cyst has a thick wall, calcification, solid nodules within the cyst, or increased blood vessels, the risk of kidney cancer cannot be ignored.

The rate of kidney cancer developing from complex cysts is estimated at 15 - 50% depending on the severity.

Lost kidney due to subjective "benign tumor"

Ms. QTD (71 years old, Binh Duong ) discovered a kidney cyst a long time ago so she did not pay attention. Recently, she had a dull pain in her right flank for more than a month, and after treating her bone and joint pain, it did not go away, so she went to the doctor and discovered a complex kidney cyst of about 5cm. The kidney tumor was a mixed cyst, thick wall, with septa and tumor buds, classified as Bosniak 4.

The doctor concluded that this type of kidney cyst was likely to develop into cancer and needed early surgery. The doctors endoscopically removed part of the upper pole of the right kidney, removing the entire kidney cyst with the tumor. The test results showed kidney cancer. The doctors predicted an 80-90% chance of recovery, but Ms. D. needed to have regular check-ups every 3 months so that the doctor could assess the risk of cancer recurrence.

A 49-year-old female patient ( Hanoi ) was admitted to the 108 Central Military Hospital with symptoms of prolonged hematuria and pain in the right lumbar region lasting more than 1 month, a history of bilateral congenital polycystic kidney disease discovered many years ago, end-stage chronic renal failure, undergoing dialysis twice a week.

The doctor examined and found the abdomen to be large and firm on both sides, the right side being larger, with pain on pressing on the right side, weak constitution, anemia syndrome; CT scan of the urinary system showed polycystic kidneys on both sides, the right side had bleeding in the cyst, the kidney was 15cm in size. The doctors performed surgery to remove a tumor of more than 30cm, weighing 2.8kg.

According to doctors, kidney cysts are a common disease in the population but most are benign, less than 1% of cases turn malignant. Currently, medicine does not know the cause of kidney cysts turning into cancer, but doctors have performed surgery on many cases.

According to Dr. Yen Lam Phuc (103 Military Hospital), kidney cysts are small water sacs located in the kidneys. These water sacs do not appear naturally, most of them are due to genetics. That is, the patient is born with kidney cysts and they gradually get bigger with age. The kidney cysts contain fluid inside. Fluid from the intercellular spaces and from the lymphatic system seeps in.

Kidney cysts will gradually grow over the years and we will only detect them at some point. Kidney cysts mainly appear when we reach the age of 50. Kidney cysts are benign, we can completely live with them except for major problems.

Doctor Cuong explained that kidney cysts 3cm or smaller are benign and asymptomatic, only discovered by chance during a health check-up, do not require treatment, and require periodic monitoring every 3-6 months.

When the cyst is larger than 3cm, complications such as bleeding, infection or malignancy can arise. Patients show symptoms such as persistent back pain, fever and chills, abnormally high blood pressure, blood in the urine, cloudy urine...

Large benign renal cysts only require aspiration of fluid or resection of the cyst tip. For renal cysts at risk of cancer (Bosniak 3 or 4), surgery is required to remove the entire cyst.

Benign but complications are also dangerous

Mr. Nghiem Trung Dung, director of the Center for Nephrology, Urology and Dialysis (Bach Mai Hospital), said that there are two types of kidney cysts: hereditary and acquired. Hereditary kidney cysts, commonly known as polycystic kidneys, are characterized by the appearance of kidney cysts on both sides with different sizes like bunches of grapes.

Acquired renal cysts often appear alone (simple renal cysts) or in multiple cysts (2 or more cysts), the cause is unknown but often occurs in people over 60 years old, people with kidney failure on dialysis.

Simple renal cysts are a common clinical condition. This is a common benign condition, the second most common among cystic kidney diseases. The incidence in men is twice that in women and increases with age. The disease usually begins after age 40.

Although simple renal cysts are benign, they can cause many inconveniences such as hematuria and lower back pain, making the patient very frustrated and uncomfortable. In many cases, there are no specific symptoms and the patient only accidentally discovers them through an ultrasound health check. However, when the cysts are large enough, they can cause symptoms such as lower back pain or heaviness in the lower back on the side of the kidney with the cyst, which is a common symptom; fever when the cyst is infected; blood in the urine, bleeding in the cyst...

The disease may be associated with hypertension due to large cysts compressing the blood pressure regulation mechanism in the kidney. Rarely, renal cysts are detected by palpation of abdominal mass when the cyst is too large. All symptomatic patients need careful screening for malignancy in the cyst.

Simple renal cysts larger than 6cm, causing severe pain or high blood pressure, depending on the location, can be treated by percutaneous aspiration, injecting sclerosing agents into the cyst after aspiration to reduce cyst fluid secretion, reducing the risk of recurrence. Similarly, many cases of polycystic kidney disease are only detected when the cyst is large and has complications.

In patients with polycystic kidney disease and associated heart valve abnormalities, statistics show that abnormalities in one or more heart valves can be seen in 18% of patients.

According to research, about 50% of patients with polycystic kidney disease have cysts in the liver. In addition, patients also have symptoms in other organs: cysts can be seen in the pancreas and spleen, the incidence is 10% and 5%, sometimes cysts are also found in the esophagus, ureter, ovary, brain.

50% of kidney cancer cases occur in patients with polycystic kidney disease. Mainly renal cell cancer, a few renal papillary cancer... Doctors recommend that people should have regular health check-ups and abdominal ultrasound is a simple, inexpensive technique that can help detect early stage kidney tumors, thereby helping with effective treatment and better quality of life.

Renal cysts may not be dangerous, but sometimes they are difficult to cure completely. Current treatments for renal cysts are mainly aimed at improving symptoms if any and preventing the development of renal cysts. However, patients do not need to worry too much because most cases can live healthily with renal cysts when following the doctor's treatment measures, only a few cases need dialysis or kidney transplant.