The myriad presenting features can challenge the most astute diagnostician. Often, the symptoms do not suggest renal abnormalities. Each year in the United States, there are 27,600 new cases of renal cell carcinoma and 11,300 deaths from this cancer.
Affected men outnumber affected women two to one.
The peak age of incidence is 60 years. Risk factors include heavy cigarette smoking and occupational exposure to cadmium. Familial forms of the disease have been associated with genetic translocations between chromosomes 3 and 8 or chromosomes 3 and 11. In addition, phakomatoses such as von Hippel-Lindau disease are associated with renal cell cancer that is often multifocal or bilateral. Although the classic triad of hematuria, abdominal mass, and flank pain is very suggestive of a renal neoplasm, it occurs in fewer than 10 percent of cases.