Renal Cell Carcinoma Differential Diagnoses

Updated: Mar 21, 2023
  • Author: Kush Sachdeva, MD; Chief Editor: E Jason Abel, MD  more...
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Diagnostic Considerations

Renal cell carcinoma (RCC) is a diagnostic consideration when a renal mass is found on a radiologic study. In 25-30% of cases, renal cell carcinomas are found incidentally in asymptomatic patients.

A renal mass of indeterminate etiology should be monitored periodically by imaging study such as intravenous pyelography (IVP), ultrasonography, or computed tomography (CT) scanning. A cystic mass can be simply observed; however, patients with a solid mass should have a complete workup, including evaluation for metastatic disease and vascular extension of the primary tumor.

Other diagnostic considerations in patients with a renal mass include the following:

  • Abscess

  • Angiomyolipoma (benign neoplasm)

  • Metastasis from a distant primary lesion

  • Metastatic melanoma

  • Oncocytoma (benign neoplasm)

  • Renal adenoma (benign neoplasm)

  • Renal cyst

  • Renal infarction

  • Sarcoma

Excruciating, sharp, bandlike back pain may be an early warning for spinal cord compression due to metastatic renal cell carcinoma and should not be ignored. Urgent magnetic resonance imaging should be performed to rule out cord compression, and high-dose dexamethasone therapy should be started.

Go to Clear Cell Renal Cell Carcinoma and Sarcomatoid and Rhabdoid Renal Cell Carcinoma for complete information on these topics.

Differential Diagnoses