Papillary Renal Cell Carcinoma: Causes, Signs, and Treatment

Written by Medicover Team and Medically Reviewed by Dr Avinash Gottumukkala , Urologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Papillary renal cell carcinoma (PRCC) is a type of kidney cancer that begins in the cells lining the kidney tubules. It can affect kidney function and, in some cases, spread to nearby lymph nodes or other parts of the body. The impact on health depends on the tumor's size, grade, stage, and overall kidney function.

What are the Symptoms of Papillary Renal Cell Carcinoma?

Papillary renal cell carcinoma may not cause symptoms in its early stages and is sometimes detected incidentally during imaging. When symptoms occur, they may include blood in the urine, pain, unexplained weight loss, and fatigue.

Blood in the urine
Persistent lower back pain or pain in the side
Fatigue
Unexplained weight loss
Anemia
Persistent fever
Swelling in the legs or ankles, particularly in advanced disease

These symptoms can have many causes, so medical evaluation is important when they persist or worsen.

What are the Causes of Papillary Renal Cell Carcinoma?

The exact cause of papillary renal cell carcinoma is not always known. It develops when genetic changes cause kidney cells to grow and divide abnormally. Some inherited conditions and acquired risk factors can increase the likelihood of developing PRCC.

Genetic changes affecting kidney cell growth
Inherited conditions such as hereditary papillary renal cell carcinoma
Smoking
Obesity
High blood pressure
Long-term dialysis and acquired cystic kidney disease
Exposure to certain occupational chemicals or toxins

When to See a Doctor?

Seek a urologist's medical attention if urinary symptoms or unexplained systemic symptoms occur, as early evaluation can help identify kidney cancer and other conditions that may cause similar symptoms.

Blood in the urine or persistent lower back or side pain
Unexplained weight loss or persistent fatigue
Persistent fever or swelling in the legs

Get medical help immediately if:

Severe or rapidly worsening pain
Significant blood in the urine or difficulty urinating
Severe weakness, dizziness, or rapidly worsening overall health

These symptoms require prompt medical evaluation to determine the underlying cause and appropriate treatment.

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How Is Papillary Renal Cell Carcinoma Diagnosed?

Papillary renal cell carcinoma is diagnosed using a combination of medical history, physical examination, imaging studies, laboratory tests, and, when necessary, a biopsy.

Imaging tests such as CT scans or MRI can identify kidney masses and help determine their size, location, and extent. Blood and urine tests can assess kidney function and detect abnormalities such as blood in the urine.

In selected cases, a biopsy may be performed to examine kidney tissue under a microscope and determine the type of tumor. Pathological and molecular testing may provide additional information that helps guide treatment.

Imaging tests such as CT scans, MRI, or ultrasound
Kidney tumor biopsy when indicated
Blood tests to assess kidney function and overall health
Urine tests to detect blood or other abnormalities
Pathological and molecular evaluation of tumor tissue when required

What are the Treatment Options for Papillary Renal Cell Carcinoma?

Treatment for papillary renal cell carcinoma depends on the stage, tumor size, location, grade, molecular characteristics, kidney function, and overall health of the patient.

Surgery: Partial nephrectomy may be used to remove the tumor while preserving as much healthy kidney tissue as possible. Radical nephrectomy, which removes the entire kidney, may be recommended for larger or more complex tumors.
Active surveillance: Selected small, slow-growing kidney tumors may be monitored with regular imaging, particularly when immediate treatment is not necessary or surgery may pose significant risks.
Targeted therapy: Targeted medicines may be used for advanced or metastatic disease based on the patient's cancer characteristics.
Immunotherapy: Immune-based treatments may be considered for selected patients with advanced kidney cancer, sometimes in combination with other systemic therapies.
Clinical trials: Clinical trials may provide access to newer treatments or treatment combinations being investigated for advanced papillary renal cell carcinoma.

Radiation therapy is not usually the primary treatment for localized PRCC but may sometimes be used to control symptoms or treat selected areas of metastatic disease.

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What are the Risk Factors of Papillary Renal Cell Carcinoma?

Several factors may increase the risk of developing papillary renal cell carcinoma. Some are related to inherited genetic conditions, while others are associated with lifestyle or kidney-related conditions.