종 양

1) 신세포암 (Renal Cell Carcinoma) - 3% of adult cancer - 85% of all primary malignant tumor - 40-50대에 흔히 발생, 남녀비는 2 대 1 (1) Etiology ① associated with von Hippel-Lindau disease, horseshoe kidney, adult polycystic kidney disease, acquired renal cystic disease from CRF ② cigarette smoking - up to 30% ③ analgesic abuse - phenacetin ④ coffee, diuretics, obesity, estrogen ⑤ familial form - autosomal dominant ⑥ translocation of cellular oncogen:c-myc, c-ras (2) Pathology 1> Origin: proximal renal tubular epithelium 2> Gross - yellow to orange - hemorrhage, necrosis, calcification 3> Micro - clear cell, granular cell, mixed sarcomatoid cell 4> Pattern of progression - direct invasion through the renal capsule into perinephric fat - direct extension into the renal vein - metastatsis at presentation - 30% - most common site of distant metastasis - lung, liver, bone (3) Staging Robson and TNM classification (교과서 표 15-1) (4) Clinical finding 1> Symptoms and signs - incide…
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