230-RCC and TCC

Question 1

classic triad of RCC? what is the only known risk factor?

Answer 1

Gross hematuria, flank pain, palpable mass

smoking (more correlation with bladder cancer)

Question 2

What are the three most common types of RCC

Answer 2

Clear cell (75%), papillary, chromophobe

Question 3

Where do the different RCC arise from?

Answer 3

Clear cell: prox tubule. Papillary: prox tubule. Chromophobe cell: intercalated cell of cortical collecting duct

Question 4

inherited vs sporadic RCC

Answer 4

inherited is multi focal, smaller, bilateral, younger pt, AD

Question 5

pathogenesis of clear cell RCC

Answer 5

HIF alpha doesn’t get ubiquinated by VHL so it doesn’t get destroyed. Instead it goes into nucleus and increases transcription of VEGF

Question 6

VHL syndrome: what is the gene and location? what is the renal and other manifestations?

Answer 6

VHL, 3p25
Clear cell RCC
Retinal and CNS hemangioblastomas, pheos, pancreatic cysts and neuroendocrine tumors

Question 7

Hereditary papillary RCC: what is the gene and location? renal manifestations?

Answer 7

MET, 7q31

Papillary RCC type 1

Question 8

Hereditary Leiomyomatosis RCC: what gene and where? renal manifestations?

Answer 8

FH, 1q42-43

Papillary RCC type 2, collecting duct carcinoma

Question 9

Birt-Hogg-Dube: what is the gene and location? Renal manifestations? what are the other manifestations

Answer 9

BHD, 17p11.2
Hybrid oncocytic RCC, chromophone RCC, clear cell RCC,
papules on nose, spontaneous pneumothorax

Question 10

Most common urothelial carcinomas in order of frequency? where is most common?

Answer 10

transitional cell carcinoma&raquo_space; squamous > adenocarcinoma

bladder&raquo_space; upper tracts > urethra

Question 11

treatment of superficial bladder cancer? of invasive bladder cancers?

Answer 11

Intravesical BCG

radical cystectomy