Presentation
Although renal tumors in adults typically present incidentally, younger patients are typically diagnosed following symptomatic presentations. In a meta-analysis, Sausville et al.[12] reported a symptomatic presentation rate of 88% in 132 patients from 8 different studies. The symptoms included abdominal pain (43%), hematuria (37%), abdominal mass (16%), fever (13%), and weight loss (5%).[5,8,12,13–18]
Furthermore, when looking at patients younger than 30 years, Akhavan et al.[3] demonstrated that the younger age was associated with higher stage, higher grade, and larger tumors at presentation.[4] Syed et al. used the SEER database to retrospectively evaluate factors that help distinguish RCC from other renal tumors. They identified 281 patients with RCC out of a total 3670 patients between the ages of 0 and 19 years with renal tumors from 1973 to 2013.
Additionally, up to 33.33% of patients present with positive lymph nodes,[3] and 30% have metastatic disease at time of diagnosis.[12] Theories on the cause of advanced presentation of renal cell carcinoma in young patients include more aggressive tumor biology, limited routine cross-sectional imaging in children, and missed diagnosis as a result of the low incidence.
Curr Opin Urol. 2019;29(5):500-504. © 2019 Wolters Kluwer Health, Inc.
