ISSN 2398-2977      

Kidney: renal carcinoma

pequis

Introduction

  • Cause: tumors are derived from renal tubular epithelial cells.
  • Signs: disease often presents late in its course since signs are often not evident until the tumor reaches a relatively large size and/or has already metastasized. Clinical signs are usually non-specific.
  • Diagnosis: urinalysis, rectal examination, renal biopsy, perineocentesis, renal perureteral endoscopy, scintigraphy, ultrasonography.
  • Treatment: generally no realistic treatment options once diagnosis has been made.
  • Prognosis:  poor.
  • Primary renal tumors are uncommon with renal carcinoma the best described entity.
  • Nephroblastomas may be encountered in younger horses.
  • Secondary tumors are more common than primary renal tumors and include hemangiosarcoma, lymphoma and dysgerminoma. 
  • Melanomas also occur with some frequency even in the non-malignant form.

Pathogenesis

Etiology

  • Unknown.

Pathophysiology

  • Renal carcinomas are typically aggressive tumors capable of widespread metastases, most commonly to the liver and lungs
  • Once the diagnosis is made, the tumors are usually at an advanced stage.  The course of disease is not established because most cases are presented in an advanced stage. 
  • A careful history might establish recurrent mild but progressive colic Abdomen: pain - adult, back pain Musculoskeletal: back pain and hematuria Urine: hematuria.
  • So far only unilateral cases have been reported. 
  • Since renal function can be maintained by the contralateral kidney, signs of renal failure are not usually prominent.
  • Metastatic disease occurs rapidly with reported sites including liver, peritoneum, lungs, skeletal muscle, pancreas, thyroid glands, mouth and bone. 
  • Signs of paraneoplastic syndrome (hypercalcemia Blood: biochemistry - calcium, anemia, hyperfibrinogenemia and dysproteinemia can be present. These signs are typically non-specific.

Timecourse

  • Although these tumors may initally grow slowly, the advanced state of disease at the time of diagnosis usually results in euthanasia soon after diagnosis.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Hollis A R (2011) Paraneoplastic syndromes. Equine Vet Educ 23 (4), 184-185 VetMedResource.
  • Davis E (2008) Diagnostic considerations for acute death in horses: How common is acute death associated with renal cell carcinoma and other neoplasms in horses? Equine Vet Educ 20 (9), 457-458 VetMedResource.
  • Knowles E J, Withers J M, Day M J & Mair T S (2008) Renal carcinoma as a cause of sudden death in an aged horse. Equine Vet Educ 20 (9), 452-455 VetMedResource.
  • Hilton H G, Aleman M et al (2008) Hand-assisted laparoscopic nephrectomy in a standing horse for the management of renal cell carcinoma. Equine Vet Educ 20 (5), 239-244 VetMedResource.
  • Murray R C & Brodbelt D C (1999) Haematuria due to renal haemangiosarcoma in a donkey. Equine Pract 21 (3), 14-17 VetMedResource.
  • Rhind S M, Hawe C, Dixon P M & Scudamore C L (1999) Oral metastasis of Renal cell Carcinoma in a horse. J Comp Path 120, 97-103 PubMed.
  • Ramirez S & Seahorn T L (1996) Ultrasonography as an aid in the diagnosis of renal-cell carcinoma in a horse. Vet Radiol & Ultrasound 37 (5), 383-386 VetMedResource.
  • Brown P J & Holt P E (1985) Primary renal cell carcinoma in four horses. Equine Vet J 17, 473-477 PubMed.
  • Traub J L, Bayly W M & Reed S M (1983) Intra-abdominal neoplasia as a cause of chronic weight loss in the horse. Comp Cont Educ 5, 526-535.

Other sources of information

  • Hollis A R (2015) Paraneoplastic Syndromes. In: Current Therapy in Equine Medicine. 7th edn.
  • Knottenbelt D C, Patterson-Kane J C & Snalune K L (2015) Clinical Equine Oncology. Elsevier, UK.

Organisation(s)

  • The Department of Veterinary Pathology, University of Edinburgh, Edinburgh, Scotland, UK.

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