In simple words: Renal pelvis cancer is often discovered during screening for other conditions because patients rarely experience symptoms until the disease has advanced. In later stages, symptoms may include constant pain in the lower back or sides, blood in urine, weakness, weight loss, anemia, and extreme tiredness. A lump or swelling may appear in the side, lower back, or abdomen if the tumor has grown very large.Diagnosis is based on history, physical exam, urinalysis, complete blood count, biopsy, ultrasound, CT, MRI, intravenous pyelogram, and PET scan. Treatment depends on the stage and severity, and may include surgical removal, chemotherapy, radiation therapy, and targeted therapy. Prognosis depends on disease severity.

Malignant neoplasm of the renal pelvis (a funnel-like structure of the kidney, where urine collects and drains into the ureter and on to the bladder) refers to cancerous growth of cells of the renal pelvis. Risk factors include smoking, obesity, high blood pressure, long-term dialysis, family history, and genetic factors.

Example 1: A 65-year-old male with a history of smoking presents with blood in his urine and persistent flank pain.Imaging reveals a mass in the renal pelvis, and biopsy confirms urothelial carcinoma., A 70-year-old female with a history of bladder cancer undergoes surveillance imaging, which detects a small tumor in the renal pelvis.She undergoes nephroureterectomy to remove the affected kidney and ureter., A 55-year-old male with chronic kidney disease experiences worsening flank pain and blood in his urine.A CT scan shows a mass obstructing the ureter, originating from the renal pelvis.Due to his existing kidney condition, he receives chemotherapy and radiation therapy to shrink the tumor without undergoing nephrectomy.

Documentation should include details of the patient's history, physical exam findings, imaging results (CT, MRI, ultrasound, IVP, PET), biopsy results with histological type and grade, treatment plan (surgery, chemotherapy, radiation, immunotherapy), and follow-up care.Details about the tumor's size, location, and stage should also be documented. Information on laterality (left or right kidney) and any associated symptoms such as hematuria, pain, or weight loss should also be included.

** Functional activity associated with the neoplasm may be identified using an additional code from Chapter 4.Malignant neoplasms of ectopic tissue should be coded to the site mentioned (e.g., ectopic pancreatic malignant neoplasms are coded to the pancreas).