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Renal Week 3 2017/18 > 9: Urological malignancies > Flashcards

9: Urological malignancies Flashcards

1
Q

Which tumours can be found in the renal pelvis?

A

TCC (urothelium)

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2
Q

What is an embryonic renal tumour found in children?

A

Nephroblastoma

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3
Q

What incidental scan often picks up renal tumours?

A

Ultrasound

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4
Q

What benign tumour is extremely common?

A

Renal cysts

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5
Q

What scans are used to view renal cysts?

A

Ultrasound

CT scan

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6
Q

When may benign renal cysts be treated?

A

Symptomatic - if they are causing pain

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7
Q

What are benign tumours associated with tuberous sclerosis?

A

Angiomyolipomas

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8
Q

What are angiomyolipomas made up of?

A

Blood vessels and fat

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9
Q

What is the main investigation for angiomyolipomas?

Why?

A

CT

Fat content is very distinctive on CT

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10
Q

What is a life-threatening complication of angiomyolipomas?

A

Haemorrhage

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11
Q

How are ruptured angiomyolipomas treated?

A

Embolisation

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12
Q

What benign renal tumour presents with a distinctive central scar?

A

Oncocytoma

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13
Q

What do

a) renal cysts
b) angiomyolipomas
c) oncocytomas

look like on imaging?

A

a) Fluid filled

b) Fatty

c) Centrally scarred

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14
Q

What is the classic triad of symptoms seen in malignant renal tumours?

A

Loin pain

Abdominal mass

Haematuria

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15
Q

What paraneoplastic symptoms are seen alongside RCC?

A

Weight loss

Anaemia

Hypertension

Hypercalcaemia

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16
Q

(Males / females) tend to get RCC.

A

Males

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17
Q

What are the two appearances of RCC?

A

Clear cell

Papillary

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18
Q

What genetic syndrome causes loads of cysts in different organs?

A

Von-Hippel Lindau syndrome

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19
Q

What is the mode of inheritance of VHL syndrome?

A

Autosomal dominant

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20
Q

In a young person with renal cell carcinoma, suspect what?

A

Von Hippel Lindau syndrome

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21
Q

How is RCC investigated?

A

Ultrasound

CT scan +/- contrast

Renal biopsy

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22
Q

Why do renal tumours cause bleeding?

A

Angiogenesis produces crap vessels

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23
Q

What staging system is used for RCC?

A

Robson score

24
Q

Where do RCCs tend to spread?

A

Renal veins

25
Q

Depending on the stage of the tumour, how is RCC treated?

A

Full nephrectomy (adrenal left unless it is affected) for advanced tumours

Partial nephrectomy for local tumours

Thermal ablation for tiny tumours or patients with one kidney or patients who can’t withstand surgery

26
Q

How are small renal masses usually picked up?

A

Incidental finding on USS

27
Q

Many surgeries are carried out for renal tumours which turn out to be ___.

A

benign

28
Q

How are patients with metastatic renal cancer managed?

A

Supportively

+/- adjuvant drugs like tyrosine kinase inhibitors

29
Q

As the stage of a cancer increases, its prognosis ___.

A

decreases

30
Q

What is the most common pre-malignant lesion of the penis?

A

Balanitis xerotica obliterans

31
Q

What does balanitis xerotic obliterans look like?

A

Scarring of the foreskin

32
Q

How is BXO treated?

A

Circumcision

and/or Dorsal slit

33
Q

What can BXO spread to affect?

A

Urethra

Glans

so management may require work on these two

34
Q

What is the malignant tumour which affects the penis?

A

Squamous cell carcinoma

35
Q

What names are given to squamous cell carcinoma-in situ of the penis?

A

Erythroplasia of Queryat (glans, shaft)

Bowen’s disease (everything else)

chronic inflammation of the squamous epithelium

36
Q

What are the

a) pre-malignant
b) in-situ
c) invasive forms of penile cancer?

A

a) BXO

b) Erythroplasia of Queryat, Bowen’s disease

c) Squamous cell carcinoma

37
Q

What does squamous cell carcinoma of the penis look like?

A

Red, raised, fungating mass

38
Q

Which virus strains are involved in SCC of the penis?

A

HPV types 16 and 18

39
Q

How is SCC of the penis staged?

A

TNM staging

40
Q

Apart from the local parts of the penis and scrotum, where else can penile cancer spread?

A

Inguinal lymph nodes

41
Q

How is penile cancer treated?

A

Surgery (penectomy)

Inguinal lymphadenectomy

or Palliative (e.g radiotherapy for those with advanced cancer, those who can’t withstand surgery)

42
Q

What is the difference between a total and partial penectomy?

A

Partial - external urethral orifice preserved

Total - patient has to void through a stoma

43
Q

What are the most common testicular tumours?

A

Germ cell tumours

44
Q

What are the two important types of germ cell tumour?

A

Seminoma

Teratoma

45
Q

How do testicular tumours present?

Are they painful?

A

Testicular swelling

Painless

46
Q

How does metastatic testicular cancer present?

A

Signs of systemic invasion

SOB

Lymphadenopathy

47
Q

What is the gold standard investigation for testicular cancer?

A

USS

48
Q

What are some markers of testicular cancer?

A

AFP

HCG

LDH

49
Q

Which marker is not produced by seminomas?

A

AFP

50
Q

Which tumours produce AFP, hCG and LDH?

A

a) Teratomas

b) Seminomas and teratomas

c) Seminomas and teratomas

So AFP seems to be the way to tell them apart

51
Q

How is testicular cancer treated?

A

Orchidectomy

removal of testicle

some cancers also respond to radiotherapy

52
Q

Where is the testicle removed in orchidectomy?

A

From the groin

so you can look at lymphatics simultaneously

53
Q

What congenital problem massively increases your chances of developing testicular cancer?

A

Undescended testes

54
Q

Men of what age tend to get testicular cancer?

A

20 - 35 years old

55
Q

Each type of testicular cancer has a different ___ in case of metastasis.

A

treatment

56
Q

Which lymph nodes do testicular cancers spread to?

A

Lumbar nodes

In the abdomen, due to the embryological origin of testes

57
Q

Which specialty deals with the treatment of metastatic testicular cancer?

A

Oncology

Renal Week 3 2017/18 (12 decks)

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