found in advance stage and have no Some of molecular markers like response to systemic therapy.4,6,7,8 carbonic anhydrase IX (CaIX), vascular Kidneys are hidden in the endothelial growth factor (VEGF), hypoxia retroperitonealwhich makes renal tumors inducible factor (HIF), Ki67 (proliferation), rarely symptomatic, except for big size p53, PTEN (phosphatase and tensin tumor. The more radiologic diagnostics are and homolog) (cell cycle), E-cadherin, used vastly, especially USG, the more have not shown a CD44 (cell adhesion) coincidental diagnosis are made.4 Three significance diagnostic value yet.14,15,16. risk factors have close influence to the Based on our data, almost all of the incidence of they are tobacco chief complaint were mass 25 (86%) and RCC, exposure, obesity and hypertension. TNM flank pain 17(59%) while classic triad of classification of renal cell carcinoma was renal tumor in 9 (31%) patients because the made in 2009. Some factors affect the advance stage of prior presentation. prognosis such as anatomical, histological, Hematuria was found in 13 (45%) patients clinical, and molecular factors. Anatomical of renal cell carcinoma which suggest a factors are size of the tumor, invasion to the suspicion of renal neoplasms besides other vein, renal capsule, adrenal gland, lymph urologic cancer.Based on the TNM system nodes and also distant metastasis. Clinical 2009,the primary tumor then most of the factors are performance state, local patients present in T2 (17/58%), T3a in symptoms, cachexia, anemia and platelet 6(21%), T4 in 5(17%) and only one patient count.9,10,11,12,13. come in T1. Based on N Staging tumor, the stage of presentation in N0 was 21(73%), Table 4.Renal based N1 5(17%) and N2 3(10%) patients. Based cell carcinoma (RCC) on 2009 TNM system9 on M staging tumor, the stage of
found in advance stage and have no response to systemic therapy.4,6,7,8 Kidneys are hidden in the retroperitonealwhich makes renal tumors rarely symptomatic, except for big size tumor. The more radiologic diagnostics are used vastly, especially USG, the more coincidental diagnosis are made.4 Three risk factors have close influence to the incidence of RCC, they are tobacco exposure, obesity and hypertension. TNM classification of renal cell carcinoma was made in 2009. Some factors affect the prognosis such as anatomical, histological, clinical, and molecular factors. Anatomical factors are size of the tumor, invasion to the vein, renal capsule, adrenal gland, lymph nodes and also distant metastasis. Clinical factors are performance state, local symptoms, cachexia, anemia and platelet count.9,10,11,12,13. Table 4.Renal cell carcinoma (RCC) based on 2009 TNM system9 Some of molecular markers like carbonic anhydrase IX (CaIX), vascular endothelial growth factor (VEGF), hypoxia inducible factor (HIF), Ki67 (proliferation), p53, PTEN (phosphatase and tensin homolog) (cell cycle), E-cadherin, and CD44 (cell adhesion) have not shown a significance diagnostic value yet.14,15,16. Based on our data, almost all of the chief complaint were mass 25 (86%) and flank pain 17(59%) while classic triad of renal tumor in 9 (31%) patients because the advance stage of prior presentation. Hematuria was found in 13 (45%) patients of renal cell carcinoma which suggest a suspicion of renal neoplasms besides other urologic cancer.Based on the TNM system 2009,the primary tumor then most of the patients present in T2 (17/58%), T3a in 6(21%), T4 in 5(17%) and only one patient come in T1. Based on N Staging tumor, the stage of presentation in N0 was 21(73%), N1 5(17%) and N2 3(10%) patients. Based on M staging tumor, the stage of
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