Diagnosis of kidney cancer

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Kidney cancer can be currently diagnosed in the early stages of the disease due to the great accessibility of various imaging tests, such as ultrasound and computed tomography (CT), and therefore rarely gives symptoms. 

However, a third of kidney cancer cases are diagnosed at advanced stages of the disease, and sometimes with metastasis (spreading to other organs).  

When diagnosed with kidney cancer, different tests must be performed.

Magnetic Resonance Imaging or MRI machine

A CT or MRI scan is essential to be able to determine the clinical stage (the extension) of the disease and to be able to plan the most appropriate treatment. 

Ultrasound on a monitor

Contrast-enhanced ultrasound may sometimes be helpful in confirming the solid nature of renal tumours. 

Cerebral CT angiography or computed tomography angiography

In certain cases, the study needs other imaging tests such as chest CT to rule out lung metastases, head CT if the patient has neurological symptoms or bone scintigraphy if the patient has undergone bone changes. 


A physical examination and a complete analysis are part of the study of the stage of the kidney tumour.

Kidney cancer can be classified using the aforementioned imaging tests. This classification is called clinical staging and is used to decide the most appropriate treatment in each case. This clinical classification (see table), the TNM, is based on tumour size, if structures near the kidney are affected (T), loco-regional lymph node involvement (N) and metastasis of the disease (M).  

Renal biopsy showing the removed kidney and the microscope

A renal biopsy is not performed routinely, but only in those cases where the aetiology of the tumour (type) is not known with certainty, or where surgical treatment is not feasible and diagnostic confirmation is needed for medical treatment.





Tumour located in the kidney and less than or equal to 7 cm in size. 



Tumour located in the kidney and larger than 7 cm in size. 



The tumour is affecting other structures such as the renal vein, the vena cava or the fatty tissue that surrounds the kidney. 


Spreading to the regional lymph nodes by the tumour, but without distant metastasis. 


T4, any N M0 

The primary tumour invades Gerota's fascia or the adrenal gland, regardless of lymph node involvement. 

Any T i N, M1 

Presence of distant metastases regardless of primary tumour size and lymph node involvement. 

For disseminated disease, patients can be classified into three risk groups associated with a different prognosis, based on other clinical and analytical parameters. 

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Substantiated information by:

Meritxell Casanovas
Mireia Musquera Felip
Oscar Reig Torras

Published: 1 February 2022
Updated: 1 February 2022

The donations that can be done through this webpage are exclusively for the benefit of Hospital Clínic of Barcelona through Fundació Clínic per a la Recerca Biomèdica and not for BBVA Foundation, entity that collaborates with the project of PortalClínic.


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