Diagnosis of kidney tumours
At an early stage, renal cell carcinomas usually produce no symptoms. Only in one in ten patients do the three typical symptoms of flank pain, blood in the urine and a palpable lump give rise to suspect a renal cell carcinoma. In some cases, the first symptoms of the disease include persistently or regularly elevated temperature, lack of appetite or weight loss. The accidental diagnosis is often established by sonography (ultrasound).
Computed tomography (CT)
Computed tomography (CT) is the most reliable method (at least 95%) to differentiate between benign and malignant kidney tumours. A CT scan also provides insights into the size of the tumour, possible metastases in the liver or the retroperitoneal lymph nodes as well as the presence of a tumour thrombus in the renal or caval vein.
Examinations of the thorax and the cranium may also be necessary for the further diagnostic investigation of the surrounding area (detection/exclusion of metastases) or for therapy monitoring at advanced tumour stages.
Magnetic resonance imaging (MRI)
As regards the assessment of kidney tumours, magnetic resonance imaging (MRI) is more or less equivalent to computed tomography, but it involves much more effort, which is why it is not among the basic diagnostic procedures. It is used predominantly in patients who are allergic to iodine-containing contrast media or suffer from chronic renal dysfunction.
MRI allows for obtaining further important insights into the tumour spread in the drainage of the venous system or differentiating between kidney tumours and complicated renal cysts.
CT scan of the lungs and the thorax
The CT scan of the lungs and the thorax serves to detect or exclude metastases in the lungs and to assess the patient’s eligibility for anaesthesia.
If the renal carcinoma is suspected to have spread into the bone system (metastases), a bone scintigraphy (nuclear scanning of bones) can be performed.