| The hypernephroma constitutes 85% of primary malignant tumours of the kidney. It constitutes 2% of all malignant neoplasias and its incident is growing, perhaps due to an improvement in diagnostic methods. It is more frequent in males.
The clinical presentation can be asymptomatic, with incidental finding of the tumor during an exam carried out for other reasons. When there are symptoms, they include haematuria, abdominal mass, pain and weight loss. Other relatively common manifestations are fever, scrotal varices and paraneoplastic symptoms such as anemia, elevation of alkaline phosphatase (Stauffer’s syndrome), hypercalcaemia, cachexia, polycythaemia, amyloidosis, thrombocytosis etc.
Given the limitation of imaging techniques for diagnosing renal masses it is recommended, generally speaking, that resection is done on all the renal lesions not of a cystic nature. Despite this, it should be remembered that there are often necrotic hemorrhages, calcification and cystification resulting in very variable macroscopic appearances characteristic of these neoplasias. Occasionally the cystic degeneration is so intense that only small nodules of tumour remnants remain and diagnosis of the hypernephroma can only be done microscopically. That is to say, from time to time some cystic lesions can also be cystified hypernephromas. The size of the renal mass should also not be used as a criterion for being benign. Nor is the systematic early detection of renal adenocarcinoma in the general population recommended, except in high-risk groups. Among these are patients with predisposing genetic disorders such as Von Hippel-Lindau disease and patients with end-stage renal disease subjected to dialysis within 3 to 5 years
In image 1 a unifocal hypernephroma is seen, while the image 2 is multifocal.
In the database of images there are different CT images of cases of hypernephroma.
Answer the autotest 
Authors
Tomás Castiella Muruzábal
Servicio de Anatomía Patológica
Juan I Pérez Calvo
Servicio de Medicina Interna
Hospital Clínico Universitario “Lozano Blesa”
Zaragoza
Translation: Kelly
Watt |
