Approach to the Renal Mass Flashcards
What type of kidney cancer is commonly associated with a solid enhancing mass?
- RCC
What is the classic triad of kidney cancer?
- flank pain
- hematuria
- palpable mass
What type of kidney cancer is associated with a solid, mildly enhancing mass?
- RCC, papillary type
What type of kidney cancer is associated with a fat density mass?
- angiomyolipoma
Which renal neoplasms are benign?
- angiomyelolipoma
- oncocytoma
- cortical adenoma
What are defining features of cortical adenoma?
- small <1 cm, cortex
- encapsulated
- grey-yellow colour
- no clear cells
What are defining features of angiomyelolipoma?
- benign
- blood, muscle, fat
What are defining features of oncocytoma?
- benign
- oncocytes (granular, eosinophilic)
Which renal neoplasms are malignant?
- RCC
- TCC
- SCC
What are defining features of RCC?
- solitary, unilateral
- grey-yellow
- necrosis, hemorrhage
- can be large
- tubular cell origin
- clear cells, eosinophilic, spindle, papillary, solid, cystic
Which familial diseases predispose you to kidney cancer?
- Von Hippel Lindau disease
- hereditary papillary kidney cancer
- HLRCC
- Birt Hogg Dube syndrome
What mutation is evident in HLRCC?
- mutations inactivate FH enzyme (Kreb’s cycle)
What can be seen on chrome phone RCC pathology?
- granular cells
What are three minimally invasive options for small renal masses?
- laparoscopic partial nephectomy
- cryoablation
- radiofrequency ablation
What criteria is used to determine prognosis in metastatic RCC?
- Motzer criteria
- low performance status
- LDH >1.5x
- anemia
- hypercalcemia
- absence of prior nephrectomy
