This page was reviewed under our medical and editorial policy by
Bertram Yuh, MD, MISM, MSHCPM, Urologic Surgeon, City of Hope | Duarte
This page was updated on June 2, 2023.
When cancerous cells develop in the renal pelvis or ureter, it’s known as renal transitional cell carcinoma, also referred to as urothelial carcinoma or urothelial cancer.
The kidneys are two bean-shaped organs on either side of the waist—closer to the back of the body than the front—and responsible for filtering waste from the blood and producing urine, which collects in the renal pelvis, an area toward the middle of each kidney.
From the renal pelvis, urine is carried out of the kidneys via a long tube (called a ureter) to the bladder, then exits the body through the urethra. The lining of the renal pelvis is made up of transitional cells that are able to bend and stretch without breaking.
When cancer grows in these pliable cells, it’s called transitional cell carcinoma (TCC). When this type of cancer develops in the renal pelvis and/or the ureter, it’s called renal transitional cell carcinoma. According to the American Cancer Society, about 5 percent to 10 percent of all kidney cancers are TCCs.
Although risk factors may increase the chance of developing cancer, they don’t guarantee someone will get it.
Renal transitional cell carcinoma (TCC) risk factors include:
Although renal transitional cell carcinoma may not cause early symptoms, as the cancerous tumor grows, patients may experience the following:
To diagnose renal transitional cell cancer, the care team may perform a variety of exams and tests, as listed below.
Physical exam: The doctor gathers the patient’s personal health history and conducts a physical exam in order to assess overall health.
Lab tests: A urine specimen is collected and evaluated in a urinalysis.
Ureteroscopy: During this procedure, a thin instrument with a lighted lens, called a ureteroscope, is used to examine the renal pelvis for suspicious areas. If abnormalities are found, a small kidney biopsy (a collection of cells from the area) may be taken to check for cancer.
Intravenous pyelogram: The care team may recommend an intravenous pyelogram, which involves injecting contrast dye into the patient's vein and then performing a series of X-rays to detect abnormalities.
Other tests may include:
Additional tests may be conducted to determine whether the cancer has spread beyond the renal pelvis.
Cancer only located in the kidney is described as localized. If it’s spread to surrounding tissues, lymph nodes and blood vessels, it’s described as regional. Metastatic renal transitional cell carcinoma has spread to other areas of the body.
If the patient has been treated successfully but the cancer returns, it’s described as recurrent.
Renal TCC is given a stage 0 through 4, based on the cancer’s size and location, as listed below.
Stage 0 urothelial cancer: Abnormal cells are found inside the renal pelvis and/or ureter, and may be stage 0a or 0is. Stage 0a describes narrow, lengthy growths that extend from inside these areas, while stage 0is describes a growth that is flat in appearance.
Stage 1 urothelial cancer: Cancer has grown from inside the renal pelvis and/or ureter to the local connective tissue.
Stage 2 urothelial cancer: Cancer has extended to the local muscle layer.
Stage 3 urothelial cancer: Cancer has spread to the kidney itself or to the fat that surrounds the renal pelvis or ureter.
Stage 4 urothelial cancer: The cancer has metastasized to one or more areas, including nearby organs, distant areas of the body, lymph nodes and the fat layer surrounding the kidney.
Learn more about stage 4 metastatic kidney cancer
The most common form of treatment for renal transitional cell carcinoma is surgery, including procedures such as:
Other types of kidney cancer treatment are still being studied and used in clinical trials. These include:
Patients may also consider asking their care team whether a clinical trial may be the right approach for them.