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What Does A Cyst On Your Kidney Mean

Rare Types Of Kidney Cancer

What are Kidney Cyst & its causes? – Dr. Vidyashankar Panchangam

Rare kidney cancers occur most frequently in children, teenagers, and young adults.

Papillary renal cell carcinoma

  • 15% of all renal cell carcinomas
  • Tumor located in the kidney tubes
  • Type 1 PRCC is more common and grows slowly
  • Type 2 PRCC is more aggressive and grows more quickly

Translocation renal cell carcinoma

  • Accounts for 1% to 5% of all renal cell carcinomas and 20% of childhood caces
  • Tumor located in the kidney
  • In children, TRCC usually grows slowly often without any symptoms
  • In adults, TRCC tends to be agressive and fast-growing

What Are The Symptoms Of Kidney Cysts

Most simple kidney cysts dont cause symptoms. You may find out you have a cyst when having imaging tests for another problem like a kidney stone or a urinary problem.

Sometimes, simple or complex kidney cysts grow too large, bleed, or get infected. You may have symptoms like:

  • blood in urine

  • frequent or urgent need to urinate

  • pain in the upper abdomen

  • tenderness or pain between the ribs and pelvis

Problems caused by kidney cysts are similar to symptoms of kidney cancer, so its important to see your doctor if you have any symptoms.

Cystic Renal Cell Carcinoma

Cystic RCC is relatively rare and comprises approximately 315 % of all cases of RCCs. It is found more commonly in younger age and in females compared with solid RCC . The cystic appearance can be related to their inherent architecture or secondary to cystic degeneration and extensive necrosis . Clear cell type RCC is the most common subtype, followed by papillary and chromophobe RCC. Clear cell type RCC can show a dominant cystic component or can arise in a simple cyst . Multilocular cystic RCC of low malignant potential is a rare variant of clear cell type RCC with no reported recurrence or metastasis. This tumor is composed exclusively by cysts with low-grade tumor cell and shows a variable imaging appearance, which ranges from category IIF to category IV renal cysts . Papillary RCC can appear as a cyst with hemorrhagic or necrotic content and a thick pseudocapsule . Cystic renal RCCs have a more favorable prognosis of all subtypes of RCC: they have a low Fuhrman grade, grow slowly, and rarely metastasize or recur .

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What Is Polycystic Kidney Disease

Some people inherit a gene from a parent that causes many cysts to form in the kidneys. This condition is polycystic kidney disease . Although these cysts dont cause cancer, they can make the kidneys too large and affect kidney function.

People with PKD are at risk for kidney failure. When you have kidney failure, the kidneys struggle to remove waste from the body. People with severe kidney failure may need a kidney transplant or use a dialysis machine to filter blood. Nearly half a million Americans have PKD.

PKD is different from acquired cystic kidney disease . ACKD affects people who are on dialysis due to chronic kidney disease. The condition causes multiple cysts to form in the kidneys. These cysts are often harmless, don’t cause damage to the kidneys, and dont require treatment. About 6 in 10 people who are on dialysis for 2 to 4 years develop ACKD.

Treatment For Kidney Lesions

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The treatment of the kidney lesions may vary, it will depend on the causative factor.

The physician will decide whether the person needs conservative line of treatment or more invasive procedures such as surgery. In malignancy he may require chemotherapy or radiation as the doctor suggests. Hemodialysis may be necessary if the kidney is not functioning.

In addition to the above mode of treatment, certain home remedies and natural cures are valuable for kidney lesions.

  • The herb Hoelen is useful to stop the kidney lesion. It is said to be an immune suppressant.
  • Cut down intake of meat, poultry and fish as they are known to increase the uric acid that forms the kidney stone.
  • Water melon is the best diuretic and helps to increase the urine outflow. You can drink the juice or simply eat sliced watermelon.
  • Uva ursi is an anti inflammatory and antibacterial for kidney. It prevents bleeding if the kidney disease is mild.

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How Are Simple Kidney Cysts Diagnosed

Simple kidney cysts are often found while the patient is seeing the doctor about another condition. The most common tests used to diagnose simple kidney cysts include:

  • Ultrasound: High-frequency soundwaves and echoes create images of the inside of the body.
  • Computed tomography : X-rays and computers produce images of a cross-section of the body.· The scans require an injection of iodinated contrast n order to distinguish fluid-only filled cysts from solid masses.
  • Magnetic resonance imaging : Magnets, radio waves and a computer create images of inside the body. They also can be used to tell the difference between cysts filled with fluid and solid masses. Because they don’t require iodinated contrast, MRIs are used for patients with iodine allergy.

What Happens To Patients With Renal Cell Carcinoma

Prognosis in patients with renal cell carcinoma

In general, the prognosis and prediction of outcomes after treatment for RCC is generally based on tumor-specific factors and patient-specific factors . Based on large studies of patients with RCC, prognostic scoring systems have been developed and validated.

  • Tumor Node Metastasis staging system

  • Memorial Sloan Kettering Cancer Center validated by the Cleveland Clinic Foundation

  • UCLA Integrated Staging System

  • Stage Size Grade and Necrosis scoring system for clear cell RCC emphasis on histologic/pathologic features of clear cell RCC

  • Fuhrman Nuclear Grading System for RCC

Tumor Node Metastasis staging system:

This system is used to give general prognostic information based on the extent of tumor burden . This system is used to evaluate survival up to 5 years post-diagnosis, based on the stage at the time of diagnosis.

For stages I, II, III, and IV the 1, 2, 3, 4 and 5 year survivals are approximately as follows: respectively.

Memorial Sloan Kettering Cancer Center:

This system is perhaps the most widely used and most well validated scheme for prognostic stratification. This system is based on clinical factors and was developed based on outcomes of patients with advanced RCC. The system has also been validated by the Cleveland Clinic Foundation. Five factors are used to estimate survival in patients with advanced disease:

Based on these five factors, 3 risk categories are determined and correlate with survival data.

Table 2.

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Symptoms Of Kidney Cancer

In many cases, there are no obvious symptoms at first and kidney cancer may only be found during tests for another condition or reason.

If there are symptoms, they can include:

  • blood in your pee you may notice your pee is darker than usual or reddish in colour
  • a persistent pain in your lower back or side, just below your ribs
  • a lump or swelling in your side

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What Causes Autosomal Recessive Pkd

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Like ADPKD, autosomal recessive PKD is an inherited disease. In this case, however, a child may be born with the disease only if both parents are carriers of the gene that causes it. A carrier is someone who has the gene but does not have the disease. When both parents are carriers of the gene that causes ARPKD, their child has a 1 in 4 chance of being born with ARPKD. The child has a 1 in 2 chance of being a carrier of the gene that causes ARPKD and a 1 in 4 chance of neither having the disease nor being a carrier of the gene. The disease usually does not affect every generation of a family.

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How Are Simple Kidney Cysts Treated

In most cases, simple kidney cysts don’t need to be treated. However, if a cyst is putting too much pressure on another organ or is affecting the way a kidney works, it might be necessary to shrink or remove the cyst. There are 2 procedures that are most commonly used to treat simple kidney cysts:

  • Aspiration and sclerotherapy: The doctor inserts a long needle under the skin to puncture the cyst and drain the fluid. A strong solution is then injected into the cyst to shrink it. This procedure can be repeated, if necessary.
  • Surgery: Surgery to remove a cyst can usually be done laparoscopically, using thin instruments inserted through small holes in the abdomen. During surgery, the doctor first drains the cyst and then cuts or burns away the cyst itself.

Kidney Tumor With Suspicion Of Spread

You may have been told that the kidney cancer has spread. This could be to lymph nodes, the lungs, liver, bone, or even the vena cava â the largest vein in your body.

About 1/3 of patients find that the cancer has spread even without any symptoms.

For those with symptoms, you may have experienced abdominal or back pain, blood in the urine, bone pain, seizures, or even bad headaches. After a full evaluation of the extent of spread a treatment plan should be formulated.

This can get quite complicated and a multidisciplinary team who specialize in kidney cancer would be best to help with this. It is important that an urologist and medical oncologist collaborate in constructing an optimal plan for your care. This multidisciplinary approach is most important for cancers with a high suspicion of spread! This is because today there are numerous options and combinations for patients with metastatic kidney cancer.

These options can include:

  • Surgery In certain settings, removal of the kidney even when the cancer has already spread has been shown to improve survival. This can often be done laparoscopically so the patient can recover rapidly and promptly receive additional therapy.

  • Immunotherapy IL-2 can be a good option for some patients and can deliver excellent results for some patients. Interferon-alpha is another option.

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    Treatments For Kidney Cysts

    If you dont feel any pain from your simple kidney cyst, the doctor may not do anything right away. They may want to monitor it by taking more imaging tests at a later date.

    Medications

    If your cyst becomes infected, the doctor may recommend a course of antibiotics to treat the infection.

    Alternative therapies

    If you have symptoms, your doctor may need to perform a procedure called sclerotherapy, which happens under local anesthesia. For this treatment, the doctor inserts a needle through the skin into the cyst, removing the liquid. They then inject an alcohol solution to harden the area and ensure that the cyst doesnt fill up again.

    Surgery

    Laparoscopic surgery is sometimes necessary if the cyst is large. The surgeon drains the cyst and removes the extra tissue around it. This procedure usually occurs under general anesthesia and may require you to remain in the hospital for one or two days.

    What Causes Kidney Cysts

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    If your kidney cysts are caused by PKD, then they are inherited. This means you have them because they run in your family. For most people, though, this is not the case. Doctors arent sure why kidney cysts form for them. It could be that the kidney surface weakens over time. This could explain why kidney cysts are most common in people who are age 50 and older.

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    Cysts In Kidney: When To Be Concerned

    Many people with simple kidney cysts are asked to have a watchful waiting procedure. In other words, they are usually suggested to periodically take an imaging test to see whether the cysts are still tolerated or the treatment should be taken promptly.

    While most of the time cysts in the kidneys are considered harmless and dont require treatment, this could be different when they have caused symptoms and complications.

    Although these cysts are usually not serious or even sometime they may go away naturally without treatment, its not always easy to stop worrying about them. In general, the treatment may be suggested if some of the following conditions occur:

    What Happens If Kidney Cysts Are Not Treated Immediately

    Cysts can form in one or both kidneys and on the inside or outside of the kidneys. Although generally benign, kidney cysts still have the potential to cause serious problems if they are large or if they have been left for too long without treatment.

    Some dangers to be aware of if a kidney cyst is large or untreated is bleeding due to kidney rupture, swelling of the kidneys, as well as infection of the cyst. Untreated kidney cysts can also cause pain.

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    Diagnosis For Kidney Cysts

    An imaging test diagnoses kidney cysts. If you suspect that you have a cyst on your kidney or are experiencing symptoms, the doctor will take a look at your medical history and recommend one of the following tests for you:

    • Computed tomography scan

    A technician will perform the imaging test and collect the images. Once theyve gone over them, theyll be able to tell your doctor what type of cyst you have: simple or complex. Simple cysts dont usually require as much medical attention as complex ones. Complex cysts can be linked to cancer.

    Complex Kidney Cyst Complications

    Are cysts on the kidneys serious?

    Complex kidney cyst has its complications. Its important not to allow starting of inflammatory processes. They often occur in the fluid filling the cyst cavity.

    In addition, there may be a hemorrhagic kidney cyst. This occurs when there is bleeding inside the cyst. Blood partially or completely fills the cavities of a complex kidney cyst.

    Echinococcosis cyst is extremely unpleasant thing caused by hydatid tape worm. This disease is called hydatidosis.

    As a rule, mature worm lives in the small intestine of a dog. Man is a random intermediate master. The most common localization site is the liver. Renal hydatidosis is about 2% of human echinococcal cysts.

    Renal cancers account for about 7-10% of cystic lesions detected by ultrasound. Although the percentage is small, the risk of cancer is worth carrying out some additional diagnostic procedures to make accurate diagnose.

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    What Causes Polycystic Kidney Disease

    People who have PKD were born with it. PKD is almost always inherited from a parent or from both parents. People of all genders, ages, races, ethnicities and nationalities can have PKD. Men and women get PKD equally as often. If you have a blood relative with PKD, you are more likely to have PKD or carry the gene that causes it. If you carry the gene that causes PKD, but you do not have the disease, you are called a carrier. This is possible with autosomal recessive PKD.

    Magnetic Resonance Imaging Scan

    MRI scans may be done when a person cant have the CT contrast dye because they have an allergy to it or they dont have good kidney function. MRI scans may also be done if theres a chance that the cancer has grown into major blood vessels in the abdomen , because they provide a better picture of blood vessels than CT scans. Finally, they may be used to look at abnormal areas in the brain and spinal cord that might be due to cancer spread.

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    How Are Kidney Cysts Diagnosed

    Kidney cysts are usually found during tests for another reason. Once the cyst is found, you may need the following:

    • An ultrasound, CT, or MRI may be used to take pictures of your kidneys and any cysts. You may be given contrast liquid to help your kidneys show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with any metal. Metal may cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
    • Blood tests may be used to check your kidney function.

    What Are Causes Of Kidney Lesions

    Kidney Cysts

    Kidney lesions, also known as masses or tumors, can come from spreading cancerous cells. They also arise from fluid-filled growths called cysts. Most commonly, lesions consist of cysts, which are benign . Solid lesions turn out to be cancerous over 80 percent of the time, notes Urology Health Foundation. Doctors usually do not even biopsy solid lesions before removing them, because of the risk of false negatives and because of how rarely they are caused by anything else.

    Any anomalous growth inside the kidney is considered a lesion. Risk factors for having lesions that turn out to be cancerous include smoking, obesity, high blood pressure, a family history of kidney cancer, diet with fried meats or high caloric intake, chronic kidney failure or dialysis. Tuberous sclerosis and Von Hippel-Linday syndrome are two less-common causes, according to Urology Health Foundation.

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    What Are The Risk Factors For Kidney Cysts

    Anyone can have kidney cysts. Some infants are born with them. But older adults, especially those who smoke, are more likely to have kidney cysts. Men are twice as likely as women to have kidney cysts.

    Certain health problems may also increase your risk of kidney cysts, including:

    • chronic kidney disease

    • high blood pressure

    • medullary cystic kidney disease

    • tuberous sclerosis complex

    • Von Hippel-Landau disease

    How Are Renal Cysts Diagnosed And Evaluated

    Since they rarely cause symptoms, renal cysts are most often found during imaging tests performed for other reasons. In such cases without any symptoms, simple renal cysts are usually left alone and do not need any further tests. However, some renal cysts look more complex than the usual simple renal cyst. These complex renal cysts can have a thicker wall, or solid material inside instead of just fluid. Once complex renal cysts are discovered, additional imaging tests may be performed to monitor them and distinguish benign cysts from cancer.

    Some types of imaging tests your doctor might order include:

    Abdominal Ultrasound and Pelvic Ultrasound: These exams are performed to take pictures of the kidneys and confirm the presence of fluid inside the renal cysts. Your doctor may use ultrasound imaging to monitor renal cysts for any changes over time.

    For more information about ultrasound performed on children, visit the Pediatric Abdominal Ultrasound page.

    Abdominal and Pelvic CT: Often used as a complement to ultrasound in the study of complex renal cysts, this procedure can help distinguish benign cysts from tumors in the kidneys. A CT scan may include an injection of contrast material. See the Radiation Dose page for more information about CT procedures.

    For more information about CT performed on children, visit the Pediatric CT page.

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