canis - Articles
Kidney: neoplasia
Synonym(s): renal carcinoma
Introduction
- Rare - accounts for less than 1.7% of all canine tumors.
- Cause: primary renal tumor, metastasis from other sites or part of a systemic neoplastic disease (especially histiocytic sarcoma, rarely lymphoma).
- Signs: vague illness or associated renal failure, hematuria, flank mass.
- Diagnosis: radiography, ultrasonography, fine needle aspiration, biopsy.
- Treatment: surgery and/or chemotherapy.
- Prognosis: guarded but depends on histological type/finding and stage of the disease.
- May cause paraneoplastic syndromes, ie hypercalcemia, polycythemia.
Presenting signs
- Vague signs of illness:
- Anorexia.
- Weight loss.
- Lethargy.
- Hematuria Hematuria (associated with renal pelvis tumors or hemangiosarcoma Hemangiosarcoma).
- Abdominal distension with nephroblastoma or bilateral cystadenomas.
- Hind limb edema.
- Rarely signs of chronic renal failure Kidney: chronic kidney disease (CKD):
- Vomiting.
- Diarrhea.
- Polyuria.
- Polydipsia.
Age predisposition
- Usually older dogs (average 8 years).
- Young <1 year (nephroblastoma).
- Has been reported in older animals 5 years and above (including nephroblastoma).
Breed/Species predisposition
- Bilateral cystadenomas associated with dermatofibrosis in GSDs German Shepherd Dog.
Cost considerations
- May require extensive investigations to make a diagnosis if benign (nephrectomy Ureteronephrectomy ).
- Cure possible if tumor is benign or still totally confined within the renal capsule.
Special risks
- Must ensure remaining kidney is functional before nephrectomy.
Pathogenesis
Etiology
- Metastases from other tumors (hemangiosarcoma Hemangiosarcoma, osteosarcoma Osteosarcoma, melanoma Melanoma, mast cell tumor Skin: mastocytoma, various carcinomas) are more common than primary renal tumors.
Malignant tumors
- Over 90% of kidney tumors are malignant.
- Over 85% are epithelial in origin - most frequent is renal adenocarcinoma Adenoma / adenocarcinoma but also transitional cell carcinoma (from renal pelvis).
- Other types include nephroblastoma (Wilm's tumor) and less frequently:
- Squamous cell carcinoma Skin: squamous cell carcinoma.
- Hamangiosarcoma Hemangiosarcoma.
- Leiomyosarcoma Leiomyoma/leiomyosarcoma.
- Lymphoma Lymphoma.
- Chondrosarcoma Chondrosarcoma.
- Anaplastic sarcoma Soft tissue sarcoma.
- Carcinoma.
Benign tumors
- <10% include renal adenoma Adenoma / adenocarcinoma , transitional cell papilloma, hemangioma Hemangiosarcoma , leiomyoma and fibroma.
Pathophysiology
- Neoplastic transformation of renal tubular epithelium, epithelium of conducting apparatus, embryonal nests of metanephros (nephroblastoma) or supporting tissues.
- Renal adenocarcinomata may remain localized or metastasize very quickly via blood to lung, liver, brain, skin, eyes or bone. May invade locally to renal pelvis, ureters or adjacent blood vessels.
- Nephroblastoma often has benign course - grows slowly by expansion but occasionally may invade local tissues or metastasize to peritoneum or viscera.
- Very large tumors may put pressure on vena cava and produce hind limb edema.
- Release of factors from tumor (parathormone-like substance) or excessive bony metastasis may result in hypercalcemia Hypercalcemia: overview.
- Local renal anoxia or excessive secretion of erythropoietin by tumor may result in polycythemia.
Timecourse
- Variable - adenocarcinomata can be quite fast growing and metastasize by time of diagnosis.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Carvalho S, Stoll A L, Priestnall S L, Suarez-Bonnet A, Rassnick K et al (2017) Retrospective evaluation of COX-2 expression, histological and clinical factors as prognostic indicators in dogs with renal cell carcinomas undergoing nephrectomy. Vet Comp Oncol 15, 1280-1294 PubMed.
- Edmondson E F, Hess A M & Powers B E (2015) Prognostic significance of histologic features in canine renal cell carcinomas: 70 nephrectomies. Vet Pathol 52(2), 260-268 PubMed.
- Locke J E & Barber L G (2006) Comparative aspects and clinical outcomes of canine renal hemangiosarcoma. J Vet Intern Med 20, 962-967 PubMed.
- Eddlestone S, Taboada J, Senior D & Paulsen D B (1999) Renal hemangioma in a dog. JSAP 40 (3), 132-135 PubMed.
- Cuypers M, Grooters A M, Williams J & Partington B (1997) Renomegaly in dogs and cats Part I. Differential diagnosis. Comp Cont Ed 19 (9), 1019-1032 VetMedResource.
- Cuypers M, Grooters A M, Williams J, Partington B & Pechman R D (1997) Renomegaly in dogs and cats Part II. Diagnostic approach. Comp Cont Ed 19 (11), 1213-1229 VetMedResource.
- Moe L & Lium B (1997) Hereditary multifocal renal cystadeno-carcinomas and nodular dermatofibrosis in 51 German shepherd dogs. JSAP 38 (11), 498-505 PubMed.
- Crow S E (1985) Urinary tract neoplasms in dogs and cats. Comp Cont Ed 7 (8), 607-618 VetMedResource.