Renal Cell Carcinoma

Renal cell carcinoma, also known as hypernephroma, is characterized by the classic triad of hematuria, flank pain, and a renal mass. The development of pain may be a warning sign for metastatic disease. Pain control becomes an important issue with metastatic disease, and an intrathecal implantable pump or permanent placement of a epidural catheter for continuous delivery of pain medications may be indicated. Less than 5% of tumors of renal origin are sarcomas; most are leiomyosarcomas. The peak age is the 4th and 5th decades of life. Flank pain is usually the initial symptom, and this pain is mainly due to stretching of Gerota's fascia or compression and invasion of intercostal nerves, or both.