Benign renal tumours Flashcards
1
Q
What are some examples of benign renal tumours?
A
- Simple cysts
- Angiomyolipoma
- Oncocytoma
2
Q
What is an oncocytoma?
A
Tumour made up of oncocytes (epithelial cells with an excess amount of mitochondria)
3
Q
How do oncocytomas present?
A
- Incidental (85%)
- Loin pain
- Haematuria
4
Q
What is the difficulty in diagnosing oncocytoma?
A
They are radiologically and microscopically very difficult to differentiate from renal cell carcinomas
5
Q
What investigations are required in oncocytoma
A
CT
Biopsy
6
Q
What is shown on CT in oncocytoma?
A
Spoke wheel pattern
7
Q
What will biopsy show in oncocytoma?
A
- Mahogany brown with a central stellate scar
- Very pink and granular cytoplasm
- Aggregates of eosinophilic cells, mitosis is rare and cells packed with mitochondria
- Can be uncertain, similarities to chromophobe RCC
8
Q
How is oncocytoma managed?
A
- Observation 4-5 years if biopsy proven
- Not known to metastasize
9
Q
What is an angiomyolipoma?
A
A tumour made up of blood vessels, immature smooth muscle, and fat
10
Q
Describe the aetiology of angiomyolipoma
A
- 80% sporadic in middle aged females
- 20% in association with tuberous sclerosis
- 80% of TS patients develop AML
11
Q
Clinical presentation of angiomyolipoma
A
- Incidental (50%)
- Loin pain
- Haematuria
- Mass
- Wunderlich’s syndrome - 10%, massive retroperitoneal bleed
12
Q
Investigations required in angiomyolipoma
A
- USS - bright echo pattern
- CT - fatty tumour of low density
13
Q
Management of angiomyolipoa
A
- 4 cm is considered cut off
- Elective - embolisation, partial nephrectomy
- Emergency - embolisation, emergency nephrectomy
14
Q
A
