GRAWITZ’S TUMOR

GRAWITZ’S TUMOR

Definition of Grawitz’s tumor

• Grawitz’s tumor is a type of kidney tumor primarily composed of renal tissue and blood vessels.
• Also known as renal cell carcinoma, it is a malignant tumor that originates from the epithelial cells of the kidney.

Pathology of Grawitz’s tumor

• The tumor grows extensively in the renal parenchyma and invades the surrounding structures, including the renal capsule, fat, and blood vessels.
• Microscopically, the tumor is characterized by large, irregular cells with clear or eosinophilic cytoplasm and a prominent nucleus.
• The tumor cells are arranged in a solid or alveolar pattern and are often surrounded by a fibrotic stroma.

Types of Grawitz’s tumor

• Clear cell type: This is the most common type of renal cell carcinoma, accounting for about 70% of all cases.
• Papillary type: This type of tumor is characterized by small, finger-like projections (papillae) that grow into the renal pelvis.
• Chromophobe type: This type of tumor is characterized by large, pale cells with a distinctive cell membrane.
• Collecting duct type: This type of tumor is rare and is thought to arise from the collecting ducts of the kidney.

Clinical manifestations and diagnostic findings

• Symptoms: Patients with Grawitz’s tumor may present with a range of symptoms, including hematuria (blood in the urine), flank pain, weight loss, and anemia.
• Diagnosis: The diagnosis of Grawitz’s tumor is typically made using imaging studies, such as CT or MRI scans, which show a mass in the kidney.
• Laboratory findings: Patients with Grawitz’s tumor may have elevated levels of lactate dehydrogenase (LDH) and other tumor markers.

Management of Grawitz’s tumor

• Surgery: The treatment of choice for Grawitz’s tumor is surgical resection of the affected kidney (nephrectomy).
• Nephrectomy: This involves removing the entire kidney, along with any surrounding tissues that are affected by the tumor.
• Radical nephrectomy: This involves removing the entire kidney, along with the adrenal gland and any surrounding lymph nodes.
• Partial nephrectomy: This involves removing only the affected portion of the kidney, while preserving as much normal kidney tissue as possible.

Complications of Grawitz’s tumor

• Metastasis: Grawitz’s tumor can metastasize to other parts of the body, including the lungs, bones, and brain.
• Obstruction: The tumor can cause obstruction of the renal pelvis or ureter, leading to urinary retention and other complications.
• Hemorrhage: The tumor can cause bleeding into the renal pelvis or ureter, leading to hematuria and other complications.

Homeopathic therapeutic medicines

• Arsenicum album: Indicated for symptoms such as hematuria, flank pain, and weight loss.
• Carcinosin: Indicated for symptoms such as metastasis, obstruction, and hemorrhage.
• Phosphorus: Indicated for symptoms such as anemia, fatigue, and weakness.

Operative technique for Grawitz’s tumor

• Step 1: The patient is positioned in the supine position and the abdomen is prepared for surgery.
• Step 2: A midline incision is made in the abdomen, and the peritoneum is incised to expose the kidney.
• Step 3: The kidney is mobilized and the renal vessels are ligated and divided.
• Step 4: The kidney is removed and the abdomen is closed in layers.

Blood supply and nerve supply of the kidney

• Blood supply: The kidney receives its blood supply from the renal arteries, which arise from the aorta.
• Nerve supply: The kidney is innervated by the renal plexus, which arises from the aortic plexus and the sympathetic trunk.

Clinical anatomy of the kidney

• Location: The kidney is located in the retroperitoneal space, behind the peritoneum.
• Relations: The kidney is related to the adrenal gland, the renal vessels, and the ureter.
• Surface markings: The surface markings of the kidney include the renal notch and the renal impression.