Kidney Cancer Types

Kidney Cancer Types

Urologic surgeon S. Machele Donat emerges from surgery on a kidney tumor. Getting the right diagnosis will ensure that you get the treatment most likely to benefit you.

Urologic surgeon S. Machele Donat emerges from surgery on a kidney tumor. Getting the right diagnosis will ensure that you get the treatment most likely to benefit you.

There are 2 main types of primary kidney cancer. They are renal cortical tumors (renal cell cancer, or RCC) and upper tract urothelial tumors (transitional cell tumors). They’re different in how they develop and change over time. They have different treatments.

Renal Cortical Tumors

More than 9 out of every 10 kidney tumors are renal cortical tumors. They start in the main part of your kidney, which has structures called renal tubules.

There are many kinds of renal cortical tumors. They do not all behave the same. Your treatment depends on the type of tumor you have. This includes the type of medicine and imaging tests, and whether you need surgery. 

Most types of kidney tumors are malignant (cancer). 

Some tumors are benign (not cancer). They often do not cause symptoms unless they grow to be very large. These benign tumors cannot spread to other parts of the body. They most often are removed through surgery and do not come back. Examples of benign tumors include renal cysts, oncocytomas, and angiomyolipomas.

Clear cell renal cell carcinoma (clear cell RCC)

Clear cell carcinomas are the most common type of kidney cancer. They also respond the best to treatment with medicine.

Systemic therapy is when a medical oncologist (cancer doctor) gives you medicine. These drugs will spread in your body through your blood to treat cancer cells wherever they are.

Clear cell carcinomas make up about 9 out of every 10 kidney cancers that are metastatic (have spread) to other body parts. They make up about 7 out of every 10 cancerous kidney tumors.

Some are aggressive. Others are called indolent, which means they grow slowly. Clear cell tumors can leave the kidney and spread to other parts of the body.

Pathologists are doctors who use a microscope to diagnose disease. They will review the shape and other features of the cancer cells under a microscope. They give the cells a grade. They give a higher grade to cells that look like they’re more aggressive. High-grade tumors are more likely to come back after surgery. They also have a higher risk of spreading to other parts of the body.

Clear cell RCC has been studied the most because it is by far the most common kidney cancer. Most of the medicines we use to treat kidney cancer were developed to treat clear cell RCC.

Papillary renal cell carcinoma (papillary RCC) 

Papillary tumors make up 10 to 15 out of every 100 kidney tumors. There are different types of papillary tumors. The kinds studied the most are called type 1 and type 2 papillary RCC. 

Type 1 usually grows slowly, but there often are several tumors in 1 or both kidneys. Type 2 tumors tend to be more aggressive. It’s harder to predict how they will behave. Other kinds of papillary RCC may not fit into either of these categories.

Papillary tumors can be linked to certain syndromes that are inherited. These types of tumors include hereditary papillary renal carcinoma, hereditary leiomyomatosis, and renal cell carcinoma.

Hereditary cancer is caused by a gene change (mutation or variant). It can be passed down through the genes to generations of a family. When we say family, we mean people related to you by blood. They’re not related to you through marriage or adoption.

If your doctor thinks you have one of these syndromes, you may need genetic testing. This is important if your cancer started at a very young age or if blood relatives had the same cancer.

Chromophobe renal cell carcinoma (chromophobe RCC) 

Chromophobe tumors make up about 5 out of every 100 kidney tumors. In many people, they’re less aggressive. But they can spread just like other types of RCC.


Oncocytoma is a benign (not cancer) tumor. About 5 to 10 out of every 100 kidney tumors are oncocytomas. People who have larger oncocytomas may have surgery to remove them. This lowers the risk of complications (problems), such as pain and bleeding in the kidney.

Collecting duct tumors and renal medullary cancer

These are very rare and make up less than 1 out of every 100 kidney tumors. They’re more common in younger adults. These are very aggressive cancers that spread from the kidney early. Once they have spread, they need different types of systemic therapy than other kidney cancers.

Unclassified renal cell carcinoma (unclassified RCC) 

Unclassified tumors do not easily fit into the other categories. They look different from other tumors under a microscope. These cancers are often aggressive. Although they are rare, they make up 3 to 5 out of every 100 kidney tumors.

Upper Tract Urothelial Tumors

This type of kidney cancer starts in your renal pelvis. That’s where urine collects before it goes into the ureter, a tube that connects the kidney to the bladder. 

Urothelial tumors affect the lining of the urinary tract, including the renal pelvis, ureters, bladder, and urethra. Urothelial (transitional cell) tumors are different from renal cortical tumors. They come from a different type of cell and behave more like bladder cancer.

Surgery for these cancers is a little different. To fight urothelial tumors that have spread, we use treatments developed for bladder cancer

Because of these differences, it’s important to have a correct diagnosis of renal cortical or upper tract urothelial tumors.

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