Editing Kidney Cancer: Diagnosis and Evaluation (section)

=== History ===
* '''<span style="color:#ff0000">Risk factors for RCC</span>''': smoking, hypertension, obesity, familial syndromes, CKD
*'''<span style="color:#ff0000">Family history</span>'''
*'''<span style="color:#ff0000">Symptoms</span>'''
**'''<span style="color:#ff0000">Most (>50%) of renal masses are diagnosed incidentally</span> during an evaluation for unrelated signs or symptoms.'''
*** '''Many remain asymptomatic and nonpalpable until they are locally advanced'''
**** Flank pain is usually due to hemorrhage and clot obstruction, but can also occur with locally advanced or invasive disease.
*** The “classic triad” of symptoms associated with a malignant renal mass was hematuria, flank pain and abdominal mass
****<5% of patients in contemporary series present with these symptoms
*** '''<span style="color:#ff0000">Symptoms of advanced disease:</span>''' 
****'''<span style="color:#ff0000">Flank pain</span>'''
*****Locally advanced RCC usually presents with pain, generally from invasion of the posterior abdominal wall, nerve roots, or paraspinous muscles.
****'''<span style="color:#ff0000">Gross hematuria</span>'''
****'''<span style="color:#ff0000">Constitutional symptoms such as weight loss, fever, and night sweats</span>'''
*** New onset coughing or other respiratory issues may suggest pulmonary metastases
*** New neurologic symptoms may suggest cerebral metastases
* '''Spontaneous perirenal hemorrhage is an uncommon presentation of RCC in which the underlying mass may be obscured. Repeat CT a few months later can provide a definitive diagnosis.'''