**2. Histological subtypes**

Renal cell carcinoma is divided into several histological subtypes, of which the most common is clear cell renal cell carcinoma (ccRCC), accounting for approximately three-quarters of all kidney cancers [7]. Clear cell RCC originates from the epithelium of the proximal convoluted tubules. Most are sporadic, but there is a strong familial connection with those with a first-degree relative more likely to be effected and around 5% are associated with hereditary conditions such as Von Hippel–Lindau disease, tuberous sclerosis, and adult polycystic disease. The next most prevalent histological subtypes are papillary (10%) and chromophobe (5%) [7]. These three histological subtypes make up 90% of renal cell carcinomas and are also most common in patients over the age of 50 years. Other rarer subtypes, such as medullary and Xp11 translocation, are typically seen in younger people. A better understanding of the genetic drivers for renal cell carcinoma has led to the development of targeted systemic agents and revolutionised the metastatic treatment landscape.
