Benign Kidney Tumours

Question 1

Aetiology of angiomyolipoma?

Answer 1

80% sporadic: Middle aged female

20% assoc with tuberous sclerosis

Question 2

Pathology of angiomyolipoma?

Answer 2

Blood vessels
Immature smooth muscle
Fat

Question 3

Signs & symptoms of angiomyolipoma?

Answer 3

Incidental finding 50% of the time

• Loin pain
• Haematuria
• Mass
• Wunderlich’s syndrome (10%): massive retroperitoneal bleed

Question 4

Investigations for angiomyolipoma?

Answer 4

USS: Bright echo pattern
CT: Fatty tumour of low density

Question 5

Treatment of angiomyolipoma?

Answer 5

4cm cut off
Elective: embolization/partial nephrectomy

Emergency: Embolization, emergency nephrectomy

Question 6

Pathology of oncocytoma?

Answer 6

• Small, oval, well circumscribed

- Mahogany brown with a central stellate star

Question 7

Histology of oncocytoma?

Answer 7

Very pink and granular cytoplasm

Question 8

Histology of oncocyte?

Answer 8

Big pink cell

-Fluffy cytoplasm (granular cytoplasm) = packed with mitochondria

Question 9

Signs & symptoms of oncocytoma?

Answer 9

Incidental finding
Loin pain
Haematuria

Question 10

Investigations of oncocytoma?

Answer 10

CT: Spoke wheel pattern
Biopsy: Uncertain, similarities to chromophobe RCC

Question 11

Differential diagnoses for oncoctoma?

Answer 11

Chromophobe carcinoma (why it is taken out)

Question 12

Treatment of oncocytoma?

Answer 12

Same as RCC