Renal adenocarcinomas:

E. Frequently are signaled by gross hematuria.

DISCUSSION: Renal adenocarcinomas arise from the renal tubular cells and not from the transitional cells that line the collecting system of the kidney. Although one fifth of all patients with renal cancer may present with anemia, the most common presenting symptom is hematuria, either gross or microscopic. Ultrasonography may confirm that a renal lesion is either cystic or solid but computed tomography (CT) is probably the most accurate imaging study for diagnosing the disease. Renal adenocarcinoma is little sensitive to current chemotherapeutic agents. Radiotherapy plays almost no role in the management of the primary tumor. Operation is the treatment of choice when the disease is confined to the kidney itself or when it has extended just outside the renal capsule. An operation has little effect once the disease is extended to adjacent structures or to regional lymph nodes.