By Cathy Nelson 

Updated on October 10, 2023

 Medically reviewed by Gagandeep Brar, MD

Hypernephroma (also called renal cell adenocarcinoma or clear-cell carcinoma of the kidney) is a type of kidney cancer that begins in the lining of small tubes in the kidney known as renal tubules. Renal tubules are responsible for filtering and cleaning blood by removing waste. They also help produce urine.

Although rare, hypernephroma is the most common type of kidney cancer.1 Imaging tests and a biopsy (removing sample tissue for examination in a lab) are used to diagnose hypernephroma. Treatment and prognosis depends on the patient’s overall health and how far the cancer has spread.

This article explains hypernephroma’s symptoms, causes, diagnosis, treatment, and prognosis.  

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Hypernephroma Symptoms    

Hypernephroma may have no symptoms in the early stages. Symptoms can appear as the tumor grows. The most common symptoms are blood in the urine, pain in the flank (the area between the ribs and the hip), and a mass that can be felt.2

Other symptoms include:3

  • Loss of appetite

  • Weight loss for no known reason

  • Anemia

  • Swollen testicle4

Causes

Hypernephroma most commonly occurs in people between the ages of 40 and 60.2 It is 2 to 3 times more common in men than women, although scientists are not sure why.1

Having a rare genetic condition known as von Hippel–Lindau disease increases the risk of developing hypernephroma.5 Von Hippel-Lindau disease causes tumors and fluid-filled sacs called cysts to grow throughout the body. If the tumor or cysts are on the kidney, they can then develop into hypernephroma. It’s estimated that 20%–50% of hypernephromas are associated with the gene that causes von Hippel-Lindau disease.2

Those with a history of kidney disease or kidney failure or a family history of kidney cancer are also at increased risk of developing hypernephroma.1

Hypernephroma is also more common in smokers, and the risk is believed to increase with the amount smoked.6  

Other risk factors include:

  • High blood pressure

  • Being overweight

  • Overuse of pain medications including Tylenol (acetaminophen)

  • Workplace exposure to certain substances such as trichloroethylene, which is an industrial solvent7

Diagnosing Hypernephroma

Healthcare providers use certain tests to determine if a patient has hypernephroma. They may perform a physical exam and order blood and urine tests to look for anything abnormal.

Imaging tests that allow doctors to see inside the body are also used to look for tumors and see how far tumors have progressed. These tests include:3

  • Computerized tomography (CT) scan

  • Magnetic resonance imaging (MRI)

  • Ultrasound

If a tumor is found, a biopsy can be ordered to determine if the tumor is cancerous. A biopsy is done by inserting a thin needle into the tumor to withdraw a tissue sample. The sample is examined under a microscope to check for signs of cancer.

Once hypernephroma is diagnosed, further imaging tests may be done to see how far the cancer has spread. These include:8

  • CT scan

  • MRI

  • Chest X-ray

  • Bone scan to see if cancer has spread to the bones

Staging

How far the cancer has spread within the kidney or throughout the body determines what stage the disease is in. For hypernephroma, the following stages are used:

  • Stage 1: The tumor has not spread outside of the kidney and is 7 centimeters (cm) or smaller.

  • Stage 2: The tumor has not spread outside of the kidney and is larger than 7 cm.

  • Stage 3: The tumor is any size but has spread to nearby lymph nodes, blood vessels in or near the kidney, or fat inside or around the kidney.

  • Stage 4: The cancer has spread to other areas of the body such as the bones, liver, distant lymph nodes, or the adrenal glands.

What Are Adrenal Glands?

Adrenal glands are small glands that make hormones that help control heart rate, blood pressure, and other functions in the body. Each kidney has an adrenal gland on top of it.

Treatment for Hypernephroma

Treatment will depend on whether the cancer has spread and, if so, how far it has spread in the body. Treatment also depends on the patient’s overall health.

In cases where the tumor is small and hasn’t spread to surrounding organs, doctors may choose to do “active surveillance,” which means using imaging tests to monitor if the tumor grows.4

Surgery

Surgery is often used to remove the tumor, along with all or part of the kidney. Types of surgery for hypernephroma include:9

  • Partial nephrectomy: Removing the tumor and part of the kidney

  • Simple nephrectomy: Removing the entire kidney

  • Radical nephrectomy: Removing the kidney, adrenal gland, and surrounding lymph nodes

 Nephrectomy: Everything You Need to Know

What Are Lymph Nodes?

Lymph nodes are located throughout the body and are part of the immune system. Each node is the size of a small bean and contains white blood cells that help fight infections. Lymph nodes also remove waste products from the body’s tissues.

In certain cases in which a patient has medical conditions that prevent them from having surgery, doctors might instead use a procedure called ablation.10 During an ablation procedure, a needle is placed in the skin and guided to the tumor. Small regions of heat are then created with either radiofrequency currents or microwaves to destroy the cancer cells.

Other Treatments

If the cancer has spread, other treatments may be used instead of or in addition to surgery. They include:

  • Radiation therapy

  • Chemotherapy

  • Targeted therapy, which involves using drugs that specifically target proteins in cancer cells or block new blood vessels that feed the tumor11

  • Immunotherapy, which uses drugs to help the body’s immune system destroy cancer cells

Prognosis

The prognosis (projected outcome) for hypernephroma depends on how advanced the cancer is when it is found.

Patients who have hypernephroma have an average five-year survival rate of 76%. The five-year survival prognosis is lowest when the cancer has spread to distant places in the body and is approximately 14%. When hypernephroma is localized the five-year survival is approximately 93%.1213

Between 2014 and 2018, the average number of people who died from kidney cancer decreased for both men and women.14

If you’ve had a kidney removed, you can live a normal, healthy life with only one kidney.15 You will have to take steps to keep your remaining kidney healthy, which you should discuss with your healthcare provider.

Coping

Surgery and other treatments for hypernephroma can leave people with physical and emotional side effects. It’s important to discuss these side effects and ways to cope with your healthcare provider. Effects can linger after treatment has ended, so it’s also important to get the support you need to help you cope.

Cancer patients require regular follow-up care, including exams and tests to keep track of recovery and make sure the cancer doesn’t return.16 You can ask your healthcare provider for a survivorship care plan that will include how often you should have check-ups and tests, possible long-term effects of treatments, and healthy living suggestions.17

 Cancer Support Groups and Communities

Summary

Hypernephroma is the most common type of kidney cancer. The most common symptoms are blood in the urine, flank pain, and a mass that can be felt, although often there are no symptoms. Hypernephroma is diagnosed through physical exams, blood and urine tests, imaging tests, and biopsy. Treatments depend on how far the cancer has spread and may include surgery, chemotherapy, radiation therapy, and other therapies.